ICD-10 Coding for Nipple Discharge(N64.52)
Complete ICD-10-CM coding and documentation guide for Nipple Discharge. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Nipple Discharge
Key Information: ICD-10 code for nipple discharge
Essential facts and insights about Nipple Discharge
Primary ICD-10-CM Code for nipple discharge
Decision Criteria
clinical Criteria
- Presence of spontaneous unilateral serosanguineous discharge
documentation Criteria
- Detailed description of discharge including laterality and characteristics
Applicable To
- Spontaneous unilateral serosanguineous discharge
Clinical Validation Requirements
- Documentation of laterality, spontaneity, and discharge characteristics
- Supporting imaging or cytology results
Code-Specific Risks
- Confusing with galactorrhea or postpartum lactation
- Not specifying laterality
Coding Notes
- Ensure documentation includes discharge characteristics and any associated symptoms.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Abnormal findings on examination of breast
R89.4Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Galactorrhea not associated with childbirth
N64.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Nipple Discharge to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N64.52.
Impact
Clinical: May lead to incorrect treatment planning., Regulatory: Increases risk of audit failures., Financial: Potential for claim denials.
Mitigation Strategy
Use templates that prompt for laterality, Educate staff on documentation standards
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use N64.3 for galactorrhea and include E22.2 if hyperprolactinemia is present.
Impact
Inadequate documentation can lead to audit flags.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
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 Nipple Discharge, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Nipple Discharge
Use these documentation templates to ensure complete and accurate documentation for Nipple Discharge. These templates include all required elements for proper coding and billing.
Spontaneous unilateral nipple discharge
Specialty: OB/GYNRequired Elements
- History of present illness
- Physical examination findings
- Diagnostic tests ordered
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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