ICD-10 Coding for Poliomyelitis(A80.9, B91, G14)
Complete ICD-10-CM coding and documentation guide for Poliomyelitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Poliomyelitis
A80Primary Range
Acute poliomyelitis
This range includes all forms of acute poliomyelitis, including paralytic and non-paralytic types.
Post-polio syndrome
Covers the late effects of poliomyelitis, including new muscle weakness and fatigue.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A80.9 | Acute poliomyelitis, unspecified | Use for acute cases where the specific type of poliovirus is not identified. |
|
| B91 | Sequelae of poliomyelitis | Use for chronic effects of poliomyelitis, such as paralysis, after the acute phase. |
|
| G14 | Post-polio syndrome | Use for new symptoms such as muscle weakness or fatigue occurring long after initial polio 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 poliomyelitis
Essential facts and insights about Poliomyelitis
Primary ICD-10-CM Codes for poliomyelitis
Decision Criteria
clinical Criteria
- Presence of acute flaccid paralysis with laboratory confirmation
Applicable To
- Acute paralytic poliomyelitis
Excludes
- Post-polio syndrome (G14)
Clinical Validation Requirements
- Stool PCR confirming poliovirus
- Clinical presentation of acute flaccid paralysis
Code-Specific Risks
- Misclassification if specific virus type is known
Coding Notes
- Ensure documentation specifies acute onset and paralysis type.
B91 - Sequelae of poliomyelitis
Use for chronic effects of poliomyelitis, such as paralysis, after the acute phase.
Applicable To
- Residual paralysis from past poliomyelitis
Excludes
- Acute poliomyelitis (A80.-)
Clinical Validation Requirements
- Historical documentation of prior poliomyelitis
- Current clinical evidence of paralysis or atrophy
Coding Notes
Document the time elapsed since acute infection to support sequelae coding.
G14 - Post-polio syndrome
Use for new symptoms such as muscle weakness or fatigue occurring long after initial polio infection.
Applicable To
- New muscle weakness in polio survivors
Excludes
- Acute poliomyelitis (A80.-)
Clinical Validation Requirements
- EMG showing chronic denervation
- Exclusion of other neuromuscular disorders
Coding Notes
Ensure documentation includes onset of new symptoms and exclusion of other conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Weakness
R53.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Poliomyelitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A80.9.
Impact
Clinical: Inaccurate clinical picture, Regulatory: Potential audit failure, Financial: Incorrect DRG assignment
Mitigation Strategy
Include paralysis onset date in all clinical notes, Use standardized templates for documentation
Impact
Reimbursement: Incorrect reimbursement due to misclassification, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate health records
Mitigation Strategy
Ensure B91 is only used for chronic sequelae, not active infections.
Impact
Using B91 for active poliomyelitis can lead to audit issues.
Mitigation Strategy
Educate coding staff on the distinction between acute and chronic poliomyelitis 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 Poliomyelitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Poliomyelitis
Use these documentation templates to ensure complete and accurate documentation for Poliomyelitis. These templates include all required elements for proper coding and billing.
Acute Poliomyelitis Diagnosis
Specialty: Infectious DiseaseRequired Elements
- Onset date of paralysis
- Type of paralysis (e.g., flaccid)
- Laboratory confirmation (e.g., stool PCR)
- Vaccination history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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