ICD-10 Coding for Pica(F50.83, F98.3)
Complete ICD-10-CM coding and documentation guide for Pica. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pica
F50-F59Primary Range
Behavioral syndromes associated with physiological disturbances and physical factors
This range includes eating disorders such as pica, which is characterized by the consumption of non-nutritive substances.
Other behavioral and emotional disorders with onset usually occurring in childhood and adolescence
This range includes pica of infancy and childhood, highlighting the age-specific nature of the condition.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| F50.83 | Pica in adults | Use for individuals aged 15 and older who exhibit pica behavior. |
|
| F98.3 | Pica of infancy and childhood | Use for children aged 24 months to 14 years who exhibit pica behavior. |
|
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 pica
Essential facts and insights about Pica
Primary ICD-10-CM Codes for pica
Decision Criteria
clinical Criteria
- Patient is 15 years or older with documented pica behavior.
Applicable To
- Pica in individuals aged 15 and older
Excludes
- Pica of infancy and childhood (F98.3)
Clinical Validation Requirements
- Persistent ingestion of non-nutritive substances for at least one month
- Exclusion of cultural practices
Code-Specific Risks
- Incorrect age categorization can lead to coding errors.
Coding Notes
- Ensure age-appropriate coding and consider underlying conditions.
F98.3 - Pica of infancy and childhood
Use for children aged 24 months to 14 years who exhibit pica behavior.
Applicable To
- Pica in children aged 24 months to 14 years
Excludes
- Pica in adults (F50.83)
Clinical Validation Requirements
- Persistent ingestion of non-nutritive substances for at least one month
- Exclusion of cultural practices
Coding Notes
Ensure age-appropriate coding and consider underlying conditions.
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 Pica to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code F50.83.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials due to insufficient documentation.
Mitigation Strategy
Provide detailed descriptions of the behavior., Include specific substances and context.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with ICD-10 coding standards., Data Quality: Inaccurate data representation of patient conditions.
Mitigation Strategy
Use F50.83 for adult pica cases.
Impact
Incorrect coding based on patient age can lead to audit findings.
Mitigation Strategy
Verify patient age and use appropriate ICD-10 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 Pica, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pica
Use these documentation templates to ensure complete and accurate documentation for Pica. These templates include all required elements for proper coding and billing.
Emergency Department Note for Pica
Specialty: Emergency MedicineRequired Elements
- Substances ingested
- Duration of behavior
- Exclusion of cultural practices
- Lab results
- Imaging findings
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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