ICD-10 Coding for Syphilis(A50.0, A51.0, A51.5)
Complete ICD-10-CM coding and documentation guide for Syphilis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Syphilis
A50-A53Primary Range
Syphilis and other venereal diseases
This range includes all stages of syphilis, from congenital to unspecified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| A50.0 | Congenital syphilis, symptomatic | Use for infants with symptomatic congenital syphilis. |
|
| A51.0 | Primary syphilis of genital organs | Use for primary syphilis with genital ulcer. |
|
| A51.5 | Early syphilis, latent | Use for asymptomatic syphilis with recent infection. |
|
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 primary syphilis
Essential facts and insights about Syphilis
Primary ICD-10-CM Codes for syphilis
Decision Criteria
clinical Criteria
- Presence of symptoms in newborn
Applicable To
- Congenital syphilis with symptoms
Excludes
- Late congenital syphilis (A50.5)
Clinical Validation Requirements
- Positive serological test in infant
- Clinical signs of syphilis in newborn
Code-Specific Risks
- Misclassification if symptoms are not documented
Coding Notes
- Ensure documentation of symptoms in newborn.
A51.0 - Primary syphilis of genital organs
Use for primary syphilis with genital ulcer.
Applicable To
- Painless chancre
Excludes
- Secondary syphilis (A51.3)
Clinical Validation Requirements
- Presence of painless ulcer
- Positive treponemal and nontreponemal tests
Coding Notes
Document ulcer characteristics and test results.
A51.5 - Early syphilis, latent
Use for asymptomatic syphilis with recent infection.
Applicable To
- Early latent syphilis
Excludes
- Late latent syphilis (A52.9)
Clinical Validation Requirements
- Positive serology <2 years post-infection
- No symptoms
Coding Notes
Ensure documentation of infection duration.
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 Syphilis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code A50.0.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of non-compliance with coding standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific clinical terms, Document test results
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces accuracy of health records.
Mitigation Strategy
Document specific stage and symptoms to use the correct code.
Impact
Using A53.9 without specific documentation.
Mitigation Strategy
Ensure detailed documentation of symptoms and stage.
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 Syphilis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Syphilis
Use these documentation templates to ensure complete and accurate documentation for Syphilis. These templates include all required elements for proper coding and billing.
Primary care visit for syphilis
Specialty: Primary CareRequired Elements
- Patient history
- Physical examination
- Laboratory results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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