ICD-10 Coding for Shingles(B02.9, B02.1, B02.33)
Complete ICD-10-CM coding and documentation guide for Shingles. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Shingles
B02Primary Range
Zoster [herpes zoster]
This range includes all codes related to shingles and its complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| B02.9 | Zoster without complications | Use when shingles is present without any complications. |
|
| B02.1 | Zoster with other nervous system involvement | Use when shingles is associated with nervous system involvement like meningitis. |
|
| B02.33 | Zoster keratitis | Use when shingles affects the eye, causing keratitis. |
|
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 shingles
Essential facts and insights about Shingles
Primary ICD-10-CM Codes for shingles
Decision Criteria
clinical Criteria
- Vesicular rash in a single dermatome without systemic symptoms.
Applicable To
- Shingles without complications
Excludes
- Postherpetic neuralgia (B02.29)
Clinical Validation Requirements
- Presence of vesicular rash in a dermatomal distribution
- History of varicella infection
Code-Specific Risks
- Risk of undercoding if complications are present but not documented.
Coding Notes
- Ensure no complications are present before using this code.
B02.1 - Zoster with other nervous system involvement
Use when shingles is associated with nervous system involvement like meningitis.
Applicable To
- Shingles with meningitis
Excludes
- Zoster encephalitis (B02.0)
Clinical Validation Requirements
- CSF analysis showing lymphocytic pleocytosis
- Positive VZV PCR in CSF
Coding Notes
Sequence B02.1 before any manifestation codes.
B02.33 - Zoster keratitis
Use when shingles affects the eye, causing keratitis.
Applicable To
- Shingles with keratitis
Excludes
- Zoster conjunctivitis (B02.30)
Clinical Validation Requirements
- Slit-lamp examination showing dendritic lesions
- Positive VZV PCR from corneal swab
Coding Notes
Document specific eye findings to support this code.
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 Shingles to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code B02.9.
Impact
Clinical: Inaccurate clinical records., Regulatory: Potential audit issues., Financial: Possible claim denials.
Mitigation Strategy
Always document the side of the body affected.
Impact
Reimbursement: May lead to underpayment if complications are not coded., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Identify and document any complications to use the correct specific code.
Impact
Failure to document complications can lead to incorrect coding.
Mitigation Strategy
Ensure thorough documentation of all clinical findings.
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 Shingles, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Shingles
Use these documentation templates to ensure complete and accurate documentation for Shingles. These templates include all required elements for proper coding and billing.
Shingles with keratitis
Specialty: OphthalmologyRequired Elements
- Chief complaint
- History of present illness
- Physical examination findings
- Diagnostic test results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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