ICD-10 Coding for Neurofibroma(Q85.01, Q85.02)
Complete ICD-10-CM coding and documentation guide for Neurofibroma. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Neurofibroma
Q85.0-Q85.9Primary Range
Phakomatoses, not elsewhere classified
This range includes codes for neurofibromatosis types, which are essential for coding neurofibroma.
Neoplasm of uncertain behavior of peripheral nerves and autonomic nervous system
Used when there is suspicion of malignancy in neurofibromas.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Q85.01 | Neurofibromatosis, type 1 | Use when NF1 is confirmed through clinical criteria or genetic testing. |
|
| Q85.02 | Neurofibromatosis, type 2 | Use when NF2 is confirmed through clinical criteria or imaging. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for neurofibroma
Essential facts and insights about Neurofibroma
Primary ICD-10-CM Codes for neurofibroma
Decision Criteria
clinical Criteria
- Presence of ≥6 café-au-lait spots and genetic confirmation
Applicable To
- Von Recklinghausen's disease
Excludes
- Neurofibromatosis, type 2 (Q85.02)
Clinical Validation Requirements
- Genetic test confirming NF1 mutation
- Presence of ≥6 café-au-lait spots >5 mm in prepubertal individuals
Code-Specific Risks
- Incorrectly using unspecified codes when specific diagnosis is confirmed.
Coding Notes
- Ensure documentation includes genetic test results and specific clinical findings.
Q85.02 - Neurofibromatosis, type 2
Use when NF2 is confirmed through clinical criteria or imaging.
Applicable To
- Bilateral acoustic neurofibromatosis
Excludes
- Neurofibromatosis, type 1 (Q85.01)
Clinical Validation Requirements
- Bilateral vestibular schwannomas confirmed by MRI
Coding Notes
Document specific findings such as vestibular schwannomas.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Neurofibroma to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Q85.01.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Provide detailed descriptions of skin findings., Use specific measurements and locations.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts accuracy of clinical data.
Mitigation Strategy
Always use specific codes like Q85.01 or Q85.02 when diagnosis is confirmed.
Impact
High risk of audit if unspecified codes are used when specific diagnosis is confirmed.
Mitigation Strategy
Ensure documentation supports the use of specific codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Neurofibroma, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Neurofibroma
Use these documentation templates to ensure complete and accurate documentation for Neurofibroma. These templates include all required elements for proper coding and billing.
NF1 Surveillance
Specialty: NeurologyRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Genetic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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