ICD-10 Coding for Pseudogout(M11.20, M11.271)
Complete ICD-10-CM coding and documentation guide for Pseudogout. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Pseudogout
M11.2-M11.29Primary Range
Other chondrocalcinosis
This range covers pseudogout and its specific joint involvement.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| M11.20 | Chondrocalcinosis, unspecified site | Use when the specific joint is not identified. |
|
| M11.271 | Chondrocalcinosis, right ankle and foot | Use for acute pseudogout flare in the right ankle. |
|
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 pseudogout
Essential facts and insights about Pseudogout
Primary ICD-10-CM Codes for pseudogout
Decision Criteria
clinical Criteria
- Presence of CPPD crystals in synovial fluid.
Applicable To
- Chondrocalcinosis NOS
- CPPD without acute flare
Clinical Validation Requirements
- Imaging showing chondrocalcinosis
- Clinical diagnosis of CPPD
Code-Specific Risks
- May lead to denials if used without specifying the joint.
Coding Notes
- Ensure joint specificity for accurate coding.
M11.271 - Chondrocalcinosis, right ankle and foot
Use for acute pseudogout flare in the right ankle.
Applicable To
- Acute pseudogout flare R ankle
Excludes
- Gout (M10.-)
Clinical Validation Requirements
- Imaging showing chondrocalcinosis in the right ankle
- Synovial fluid analysis confirming CPPD crystals
Coding Notes
Document acute flare and confirm with imaging or synovial analysis.
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 Pseudogout to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code M11.20.
Impact
Clinical: Inaccurate diagnosis and treatment planning., Regulatory: Non-compliance with ICD-10 coding guidelines., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Always document the specific joint involved., Use imaging and synovial analysis to confirm diagnosis.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with ICD-10 specificity requirements., Data Quality: Inaccurate data on joint-specific pseudogout cases.
Mitigation Strategy
Use specific codes like M11.271 for joint-specific acute flares.
Impact
Audits may target claims lacking joint-specific documentation.
Mitigation Strategy
Ensure all documentation specifies the joint involved in pseudogout.
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 Pseudogout, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Pseudogout
Use these documentation templates to ensure complete and accurate documentation for Pseudogout. These templates include all required elements for proper coding and billing.
Acute pseudogout flare in the right ankle
Specialty: RheumatologyRequired Elements
- Joint examination findings
- Imaging results
- Synovial fluid analysis
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Pseudogout? Ask your questions below.