ICD-10 Coding for Positive Quantiferon Test(R76.12)
Complete ICD-10-CM coding and documentation guide for Positive Quantiferon Test. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Positive Quantiferon Test
R76-R79Primary Range
Abnormal immunological findings in serum without diagnosis
This range includes codes for abnormal immunological findings, including positive Quantiferon tests.
Encounter for screening for infectious and parasitic diseases
This range includes codes for screening encounters, relevant when Quantiferon tests are part of screening for TB.
Key Information: ICD-10 code for positive Quantiferon test
Essential facts and insights about Positive Quantiferon Test
Primary ICD-10-CM Code for positive quantiferon
Decision Criteria
clinical Criteria
- Positive Quantiferon test without active TB symptoms or findings.
documentation Criteria
- Explicit mention of Quantiferon test and exclusion of active TB.
Clinical Validation Requirements
- Positive QFT-Plus result (IFN-γ ≥0.35 IU/mL in TB1 or TB2 tubes after Nil subtraction)
- Documentation explicitly states no active TB (e.g., negative chest X-ray, absence of symptoms like cough/weight loss)
Code-Specific Risks
- Confusing with R76.11, which is for tuberculin skin test reactions.
Coding Notes
- Ensure documentation specifies the test type and excludes active TB.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Positive Quantiferon Test to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R76.12.
Impact
Clinical: Misinterpretation of patient TB status., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use templates that prompt for test type., Educate staff on documentation standards.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate health records and statistics.
Mitigation Strategy
Ensure the test type is documented as Quantiferon to use R76.12.
Impact
Using R76.11 for Quantiferon tests instead of R76.12.
Mitigation Strategy
Regular training on code differentiation.
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 Positive Quantiferon Test, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Positive Quantiferon Test
Use these documentation templates to ensure complete and accurate documentation for Positive Quantiferon Test. These templates include all required elements for proper coding and billing.
LTBI Diagnosis
Specialty: Infectious DiseaseRequired Elements
- Test name and result
- Exclusion of active TB
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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