ICD-10 Coding for Right Adnexal Cyst(N83.291, N83.201)
Complete ICD-10-CM coding and documentation guide for Right Adnexal Cyst. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Right Adnexal Cyst
N83.2-N83.29Primary Range
Noninflammatory disorders of ovary, fallopian tube and broad ligament
This range includes codes for ovarian cysts, specifying laterality and type.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| N83.291 | Other ovarian cyst, right side | Use for confirmed complex cysts requiring intervention. |
|
| N83.201 | Unspecified ovarian cyst, right side | Use for incidental findings of simple cysts without complications. |
|
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 right adnexal cyst
Essential facts and insights about Right Adnexal Cyst
Primary ICD-10-CM Codes for right adnexal cyst
Decision Criteria
clinical Criteria
- Complex cyst features on imaging
documentation Criteria
- Detailed imaging and symptom documentation
Applicable To
- Complex ovarian cyst
- Endometrioma
- Hemorrhagic cyst
Excludes
- Malignant ovarian cyst (C56.1)
Clinical Validation Requirements
- Complex septated right adnexal mass on transvaginal ultrasound
- Right ovarian tenderness on bimanual exam
- CA-125 levels between 32-200 U/mL in premenopausal women
Code-Specific Risks
- Incorrect laterality documentation
- Misclassification of cyst type
Coding Notes
- Ensure laterality is documented to avoid unspecified codes.
N83.201 - Unspecified ovarian cyst, right side
Use for incidental findings of simple cysts without complications.
Applicable To
- Simple ovarian cyst
Excludes
- Complex ovarian cyst (N83.291)
Clinical Validation Requirements
- Simple anechoic cyst <5cm diameter
- No internal vascularity on Doppler
- Asymptomatic/non-tender
Coding Notes
Document cyst characteristics clearly to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Right lower quadrant pain
R10.31Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Right Adnexal Cyst to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code N83.291.
Impact
Clinical: Affects treatment decisions and follow-up recommendations., Regulatory: Non-compliance with coding guidelines requiring complete documentation., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Always document menopausal status in patient notes., Use templates that prompt for menopausal status.
Impact
Reimbursement: May lead to reduced reimbursement due to lack of specificity., Compliance: Increases risk of audit failure due to non-compliance with coding guidelines., Data Quality: Impacts data accuracy and quality for clinical research.
Mitigation Strategy
Always verify and document the side of the cyst to use specific codes.
Impact
Failure to document laterality can lead to incorrect coding and audits.
Mitigation Strategy
Implement mandatory fields in EHR for laterality in all relevant documentation.
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 Right Adnexal Cyst, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Right Adnexal Cyst
Use these documentation templates to ensure complete and accurate documentation for Right Adnexal Cyst. These templates include all required elements for proper coding and billing.
Right Adnexal Mass Evaluation
Specialty: GynecologyRequired Elements
- Menopausal status
- Symptoms
- Imaging findings
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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