ICD-10 Coding for Stomach Virus(A08.11, A08.0, K52.9)
Complete ICD-10-CM coding and documentation guide for Stomach Virus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Stomach Virus
A08-A09Primary Range
Viral and other specified intestinal infections
This range includes specific codes for viral gastroenteritis caused by different viruses such as norovirus and rotavirus.
Other and unspecified noninfective gastroenteritis and colitis
Used when the viral cause is suspected but not confirmed, or for noninfective gastroenteritis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A08.11 | Acute gastroenteropathy due to Norwalk agent | Use when norovirus is confirmed by lab testing. |
|
| A08.0 | Rotaviral enteritis | Use when rotavirus is confirmed by lab testing. |
|
| K52.9 | Noninfective gastroenteritis and colitis, unspecified | Use when viral cause is suspected but not confirmed. |
|
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 stomach virus
Essential facts and insights about Stomach Virus
Primary ICD-10-CM Codes for stomach virus
Decision Criteria
clinical Criteria
- Positive PCR test for norovirus
documentation Criteria
- Detailed symptom documentation and lab results
Applicable To
- Norovirus infection
Excludes
- Bacterial gastroenteritis
Clinical Validation Requirements
- Norovirus identified by PCR stool testing
Code-Specific Risks
- Incorrectly coding symptoms separately when norovirus is confirmed.
Coding Notes
- Ensure lab confirmation of norovirus before using A08.11.
A08.0 - Rotaviral enteritis
Use when rotavirus is confirmed by lab testing.
Applicable To
- Rotavirus infection
Excludes
- Bacterial gastroenteritis
Clinical Validation Requirements
- Rotavirus antigen positive
Coding Notes
Ensure lab confirmation of rotavirus before using A08.0.
K52.9 - Noninfective gastroenteritis and colitis, unspecified
Use when viral cause is suspected but not confirmed.
Applicable To
- Gastroenteritis NOS
Excludes
- Infective gastroenteritis
Clinical Validation Requirements
- Negative bacterial culture with suspected viral etiology
Coding Notes
Use as a last resort when no specific viral cause is identified.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dehydration
E86.0Differential 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 Stomach Virus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A08.11.
Impact
Clinical: Leads to incorrect diagnosis and treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials and revenue loss.
Mitigation Strategy
Ensure lab results are documented in the medical record., Verify documentation before coding.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts accuracy of health data records.
Mitigation Strategy
Use specific viral code like A08.11 when confirmed.
Impact
Using unspecified codes when specific viral etiology is confirmed.
Mitigation Strategy
Ensure lab confirmation is documented and specific codes are used.
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 Stomach Virus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Stomach Virus
Use these documentation templates to ensure complete and accurate documentation for Stomach Virus. These templates include all required elements for proper coding and billing.
Suspected viral gastroenteritis in pediatric patient
Specialty: PediatricsRequired Elements
- Symptom frequency and duration
- Exposure history
- Diagnostic method
- Hydration status
- Outbreak context
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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