How To Report Systemic Lupus Erythematosus with the Correct ICD-10 Codes

by | Published on Apr 9, 2018 | Medical Coding

How to Report Systemic Lupus Erythematosus With ICD 10 Codes
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Systemic lupus erythematosus (SLE) or lupus is an autoimmune disease in which a person’s immune system is overactive and attacks various organs or cells of the body, causing severe damage and dysfunction. Often called a multi-system disease, this condition causes widespread tissue damage and inflammation in the skin, joints, lungs, kidneys, nervous system, blood vessels and other organs of the body. SLE is a chronic disease that can have different phases of worsening symptoms that alternate with periods of mild symptoms. Documentation is important to ensure appropriate care, and medical coding outsourcing is an ideal option for physicians to streamline their documentation requirements.

According to the Lupus Foundation of America, about 1.5 million Americans are diagnosed with some form of lupus. This condition strikes mostly women of childbearing age. However, men, children and teenagers also develop this condition. The most distinctive sign of SLE is a facial rash (that resembles the wings of a butterfly unfolding across both cheeks) that occurs in many but not all cases of this disease. Also, some people are born with a tendency towards developing this condition, which may be triggered by infections, certain drugs or even sunlight. While there is no exact cure for SLE, correct and timely treatment can help better control the symptoms.

Identifying Symptoms of SLE

Typically, the signs and symptoms of this condition may be mild or severe and may sometimes occur suddenly or develop slowly. Most people with SLE have mild disease characterized by episodes, called flares when signs and symptoms get worse for a while, then improve or even disappear completely for a time. The signs and symptoms a person experiences will mainly depend on which body systems are affected by the disease. Some of the common symptoms include –

  • Severe fatigue
  • Headache
  • Joint pain, stiffness and swelling
  • Skin lesions that appear or worsen with sun exposure (photosensitivity)
  • A rash on the cheeks and nose, which is called a “butterfly rash”
  • Hair loss
  • Anemia
  • Blood-clotting problems
  • Dry eyes
  • Fingers turning white or blue and tingling when exposed to cold, or during stressful periods (known as Raynaud’s phenomenon)

In addition, other symptoms may often depend on the specific body part that the disease may affect, such as the digestive tract, the heart, or the skin.

How Is SLE Diagnosed and Documented?

Diagnosing Systemic lupus Erythematosus (lupus) is often difficult as many of its signs and symptoms vary considerably from person to person over time, and may mimic those of other ailments or disorders. Rheumatologists will do a detailed physical exam to check for typical signs and symptoms of this condition and run several laboratory tests such as blood tests, erythrocyte sedimentation rate, urinalysis, kidney and liver assessment, antinuclear antibody (ANA) test and medical diagnostic imaging tests such as chest X-ray and echocardiogram to arrive at a definite diagnosis.

As there is no complete cure for SLE, treatment for this condition can help ease symptoms. Treatment modalities may mainly include – non-steroidal anti-inflammatory drugs (NSAIDs) for joint pain and stiffness, corticosteroids (to minimize the immune response), antimalarial drugs (for skin and joint problems) and immunosuppressants. This may again depend on the type and severity of symptoms and which parts of the body SLE has affected.

Rheumatologists are reimbursed for the treatments provided to their patients. The diagnosis and other tests offered must be reported on the medical claims using the correct medical codes. Medical billing and coding services provided by reputable companies can help physicians use the correct codes for their medical billing. The following ICD-10 codes are relevant with regard to SLE disease –

M32 – Systemic lupus erythematosus (SLE)

  • M32.0 – Drug-induced systemic lupus erythematosus

M32.1 – Systemic lupus erythematosus with organ or system involvement

  • M32.10 – Systemic lupus erythematosus, organ or system involvement unspecified
  • M32.11 – Endocarditis in systemic lupus erythematosus
  • M32.12 – Pericarditis in systemic lupus erythematosus
  • M32.13 – Lung involvement in systemic lupus erythematosus
  • M32.14 – Glomerular disease in systemic lupus erythematosus
  • M32.15 – Tubulo-interstitial nephropathy in systemic lupus erythematosus
  • M32.19 – Other organ or system involvement in systemic lupus erythematosus

M32.8 – Other forms of systemic lupus erythematosus

M32.9 – Systemic lupus erythematosus, unspecified

Systemic lupus Erythematosus (SLE) affects people differently. Treatments are most effective when you start them soon after symptoms develop. Diagnosing this condition requires a collective approach from a group of specialists such as nephrologists, hematologists, neurologists, rheumatologists and dermatologists (depending on your symptoms) to help with diagnosis and treatment. Prevention of lupus involves avoiding/reducing sun exposure, getting adequate sleep and taking the recommended medications.

Julie Clements

Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.

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