ICD-10 Coding for Raynaud's Phenomenon(I73.00, I73.01)
Complete ICD-10-CM coding and documentation guide for Raynaud's Phenomenon. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Raynaud's Phenomenon
I73.00-I73.09Primary Range
Raynaud's phenomenon codes
These codes cover primary and secondary Raynaud's phenomenon, with and without gangrene.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| I73.00 | Raynaud's phenomenon without gangrene | Use when Raynaud's is primary and there is no gangrene. |
|
| I73.01 | Raynaud's phenomenon with gangrene | Use when gangrene is present in Raynaud's. |
|
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 Raynaud's phenomenon
Essential facts and insights about Raynaud's Phenomenon
Primary ICD-10-CM Codes for raynaud's
Decision Criteria
clinical Criteria
- No gangrene present, primary Raynaud's symptoms
Applicable To
- Primary Raynaud's
- Idiopathic Raynaud's
Excludes
- Raynaud's with gangrene (I73.01)
Clinical Validation Requirements
- Triphasic color changes (pallor, cyanosis, erythema)
- No tissue necrosis
- Negative ANA
Code-Specific Risks
- Misclassification if gangrene is present but not documented.
Coding Notes
- Ensure documentation clearly states absence of gangrene.
I73.01 - Raynaud's phenomenon with gangrene
Use when gangrene is present in Raynaud's.
Applicable To
- Raynaud's with digital ulcers
- Raynaud's with necrosis
Excludes
- Raynaud's without gangrene (I73.00)
Clinical Validation Requirements
- Presence of digital ulcers or necrosis
- Positive imaging or biopsy for gangrene
Coding Notes
Document specific digits affected by gangrene.
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 Raynaud's Phenomenon to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code I73.00.
Impact
Clinical: Mismanagement of patient care., Regulatory: Non-compliance with coding standards., Financial: Loss of appropriate reimbursement.
Mitigation Strategy
Ensure thorough documentation review., Use checklists for gangrene assessment.
Impact
Reimbursement: Incorrect DRG assignment affecting reimbursement., Compliance: Potential audit issues due to misclassification., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Query provider for confirmation of gangrene presence.
Impact
Inadequate documentation of gangrene in Raynaud's cases.
Mitigation Strategy
Implement documentation audits and 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 Raynaud's Phenomenon, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Raynaud's Phenomenon
Use these documentation templates to ensure complete and accurate documentation for Raynaud's Phenomenon. These templates include all required elements for proper coding and billing.
Rheumatology Progress Note
Specialty: RheumatologyRequired Elements
- Subjective symptoms
- Objective findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Raynaud's Phenomenon? Ask your questions below.