ICD-10 Coding for STEC Hemolytic Uremic Syndrome(D59.31, A04.72)
Complete ICD-10-CM coding and documentation guide for STEC Hemolytic Uremic Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to STEC Hemolytic Uremic Syndrome
D59.3Primary Range
Hemolytic-uremic syndrome
This range includes all forms of hemolytic-uremic syndrome, with specific codes for infection-associated and other types.
Other specified bacterial intestinal infections
Includes codes for enterocolitis due to Shiga toxin-producing E. coli, which is often the underlying cause of STEC-HUS.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D59.31 | Infection-associated hemolytic-uremic syndrome | Use when STEC infection is confirmed and the clinical triad is present. |
|
| A04.72 | Enterocolitis due to Shiga toxin-producing E. coli | Use as the primary code when STEC infection is confirmed and precedes HUS development. |
|
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 STEC hemolytic uremic syndrome
Essential facts and insights about STEC Hemolytic Uremic Syndrome
Primary ICD-10-CM Codes for stec hemolytic uremic syndrome
Decision Criteria
clinical Criteria
- STEC confirmed and clinical triad present
coding Criteria
- Sequence A04.72 first if STEC infection is present
Applicable To
- STEC-associated HUS
Excludes
- Hereditary HUS (D59.32)
Clinical Validation Requirements
- STEC confirmed via stool culture/PCR
- Triad of microangiopathic hemolytic anemia, thrombocytopenia, acute kidney injury
Code-Specific Risks
- Confusing with atypical HUS
Coding Notes
- Ensure STEC infection is documented and confirmed through appropriate testing.
A04.72 - Enterocolitis due to Shiga toxin-producing E. coli
Use as the primary code when STEC infection is confirmed and precedes HUS development.
Applicable To
- STEC infection
Clinical Validation Requirements
- Confirmation of STEC infection through stool culture or PCR
Coding Notes
Ensure this code is sequenced before D59.31 when applicable.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute kidney failure, unspecified
N17.9Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting STEC Hemolytic Uremic Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D59.31.
Impact
Clinical: May lead to misdiagnosis or incorrect treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure lab results are included in the patient's record., Verify documentation before coding.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use D59.31 for STEC-associated HUS.
Impact
Incorrect sequencing of STEC infection and HUS codes.
Mitigation Strategy
Educate coders on proper sequencing rules and provide regular audits.
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 STEC Hemolytic Uremic Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for STEC Hemolytic Uremic Syndrome
Use these documentation templates to ensure complete and accurate documentation for STEC Hemolytic Uremic Syndrome. These templates include all required elements for proper coding and billing.
Emergency Department Note
Specialty: Emergency MedicineRequired Elements
- Reason for visit
- History of present illness
- Laboratory results
- Impression and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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