ICD-10 Coding for Orthostatic Conditions(G90.A, I95.1)
Complete ICD-10-CM coding and documentation guide for Orthostatic Conditions. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Orthostatic Conditions
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| G90.A | Postural orthostatic tachycardia syndrome (POTS) | Use for POTS with HR increase ≥30 bpm and no significant BP drop |
|
| I95.1 | Orthostatic hypotension | Use for documented BP drop with symptoms upon standing |
|
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 Orthostatic Conditions
Primary ICD-10-CM Codes for orthostatic
Decision Criteria
clinical Criteria
- HR increase ≥30 bpm on standing
documentation Criteria
- Absence of orthostatic hypotension
Applicable To
- Sustained heart rate increase upon standing
Excludes
- Orthostatic hypotension (I95.1)
Clinical Validation Requirements
- Tilt table test showing HR increase ≥30 bpm
- Exclusion of anemia, hyperthyroidism
Code-Specific Risks
- Misclassification with orthostatic hypotension
Coding Notes
- Ensure HR increase is documented without significant BP drop
I95.1 - Orthostatic hypotension
Use for documented BP drop with symptoms upon standing
Applicable To
- BP drop ≥20 mmHg systolic or ≥10 mmHg diastolic
Excludes
- Hypotension due to drugs (I95.2)
Clinical Validation Requirements
- Orthostatic vitals showing BP drop
- Exclude drug causes
Coding Notes
Ensure BP drop is documented with symptoms
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 Orthostatic Conditions to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code G90.A.
Impact
Clinical: Misdiagnosis of POTS, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure HR increase is documented, Use tilt table test results
Impact
Reimbursement: Potential denial of claims, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data
Mitigation Strategy
Query for orthostatic vitals
Impact
Incomplete documentation of BP measurements
Mitigation Strategy
Standardize orthostatic vitals recording
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 Orthostatic Conditions, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Orthostatic Conditions
Use these documentation templates to ensure complete and accurate documentation for Orthostatic Conditions. These templates include all required elements for proper coding and billing.
Orthostatic Hypotension Documentation
Specialty: Internal MedicineRequired Elements
- Orthostatic vitals
- Symptoms
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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