ICD-10 Coding for Orthostasis(I95.1, G90.3)
Complete ICD-10-CM coding and documentation guide for Orthostasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Orthostasis
I95.0-I95.9Primary Range
Hypotension
This range includes codes for various types of hypotension, including orthostatic hypotension.
Disorders of autonomic nervous system
Includes codes for autonomic disorders like neurogenic orthostatic hypotension and POTS.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I95.1 | Orthostatic hypotension | Use when there is a documented BP drop upon standing with associated symptoms. |
|
| G90.3 | Neurogenic orthostatic hypotension | Use when orthostatic hypotension is due to autonomic nervous system failure. |
|
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 orthostatic hypotension
Essential facts and insights about Orthostasis
Primary ICD-10-CM Codes for orthostasis
Decision Criteria
clinical Criteria
- Documented BP drop with symptoms upon standing
coding Criteria
- Use I95.1 when orthostatic hypotension is primary
Applicable To
- Postural hypotension
Clinical Validation Requirements
- BP drop of ≥20 mmHg systolic or ≥10 mmHg diastolic within 3 minutes of standing
- Symptoms like dizziness or lightheadedness
Code-Specific Risks
- Misclassification if BP measurements are not documented
Coding Notes
- Ensure BP measurements are documented in different positions.
G90.3 - Neurogenic orthostatic hypotension
Use when orthostatic hypotension is due to autonomic nervous system failure.
Applicable To
- Orthostatic hypotension due to autonomic failure
Excludes
- Orthostatic hypotension (I95.1)
Clinical Validation Requirements
- Autonomic testing showing failure
- Symptoms consistent with autonomic dysfunction
Coding Notes
Link to underlying neurological condition.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Headache with orthostatic component
R51.0Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Neurogenic orthostatic hypotension
G90.3Postural orthostatic tachycardia syndrome (POTS)
G90.AOrthostatic hypotension
I95.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Orthostasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I95.1.
Impact
Clinical: Inaccurate diagnosis of orthostatic hypotension., Regulatory: Non-compliance with documentation standards., Financial: Potential denial of claims due to insufficient documentation.
Mitigation Strategy
Ensure BP is measured and recorded in all required positions.
Impact
Reimbursement: Potential underpayment due to unspecified coding., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure orthostatic component is specified in documentation.
Impact
Inadequate documentation of BP changes can lead to audit issues.
Mitigation Strategy
Implement standardized protocols for BP measurement documentation.
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 Orthostasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Orthostasis
Use these documentation templates to ensure complete and accurate documentation for Orthostasis. These templates include all required elements for proper coding and billing.
Orthostatic Hypotension in Cardiology
Specialty: CardiologyRequired Elements
- BP measurements in different positions
- Symptoms upon standing
- Exclusion of other causes
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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