ICD-10 Coding for Pericarditis(I30.0, I30.1)
Complete ICD-10-CM coding and documentation guide for Pericarditis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pericarditis
I30-I32Primary Range
Diseases of the pericardium
This range includes all types of pericarditis, such as acute, chronic, and those associated with other 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 |
|---|---|---|---|
| I30.0 | Acute idiopathic pericarditis | Use when acute pericarditis is diagnosed without a specific underlying cause. |
|
| I30.1 | Infective pericarditis | Use when pericarditis is confirmed to be caused by an infection. |
|
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 acute idiopathic pericarditis
Essential facts and insights about Pericarditis
Primary ICD-10-CM Codes for pericarditis
Decision Criteria
clinical Criteria
- Presence of acute symptoms and idiopathic nature
Applicable To
- Acute pericarditis with no identified cause
Excludes
- Chronic pericarditis (I31.1)
Clinical Validation Requirements
- Widespread ST elevation on ECG
- Elevated CRP levels
- Absence of effusion or tamponade
Code-Specific Risks
- Misclassification if chronicity is not specified
Coding Notes
- Ensure documentation specifies 'acute' and 'idiopathic' to avoid misclassification.
I30.1 - Infective pericarditis
Use when pericarditis is confirmed to be caused by an infection.
Applicable To
- Pericarditis due to bacterial or viral infection
Excludes
- Tuberculous pericarditis (A18.84)
Clinical Validation Requirements
- Positive PCR for specific organism
- Purulent fluid from pericardiocentesis
Coding Notes
Document the specific infectious agent to ensure accurate coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Pericardial effusion (noninflammatory)
I31.3Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Pericarditis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I30.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for incorrect billing.
Mitigation Strategy
Always specify acute vs. chronic in documentation., Review documentation for completeness.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Query for specific cause and use the appropriate code.
Impact
High risk of audit if unspecified codes are used when specific codes are applicable.
Mitigation Strategy
Implement regular documentation audits and coder training.
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 Pericarditis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pericarditis
Use these documentation templates to ensure complete and accurate documentation for Pericarditis. These templates include all required elements for proper coding and billing.
Acute idiopathic pericarditis
Specialty: CardiologyRequired Elements
- HPI with symptom description
- ECG findings
- Laboratory results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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