ICD-10 Coding for Pemphigus, an Autoimmune Disease

ICD-10 Coding for Pemphigus, an Autoimmune Disease

Pemphigus is a rare group of autoimmune diseases that causes blisters and sores on the skin and inside the mouth, nose, throat, eyes, and genitals. These lesions that form quickly may last for years, with new blisters appearing in the same area of the skin after one blister goes away. Certain risk factors for this disease include age, geographic location, genes and medications. Dermatologists diagnosing and treating this skin condition can rely on professional dermatology medical billing services provided by experienced medical coding companies.

Pemphigus mainly affects the outer of the skin (epidermis) and causes lesions and blisters that are easily ruptured. It tends to be a long-lasting or chronic condition, and some types can be life-threatening without treatment. However, the condition isn’t contagious and the symptoms can be managed with medications to help the skin heal.

Pemphigus Types

There are different types of pemphigus. It is categorized, based on the layer of skin where the blisters form and where the blisters are found on the body.

  • Pemphigus Vulgaris (PV) – This is the most common condition, where blisters may form at the mouth first and then spread to the skin and in other mucous membranes, even the genitals. Blisters can be painful, making it difficult to chew and swallow.
  • Pemphigus Foliaceus (PF) – This type of pemphigus forms blisters only on the skin and often develops on the face, scalp, and upper body, not in the mouth.
  • Pemphigus Vegetans – This type can cause blisters on the groin, under the arms, and on the feet.
  • IgA Pemphigus – Caused by the IgA antibody, this type resembles pemphigus foliaceus or may appear as small pustules. The two distinct subtypes are – subcorneal pustular dermatosis (SPD) and intraepidermal neutrophilic dermatosis (IND).
  • Paraneoplastic Pemphigus (PNP) – This type is characterized by painful blisters in the mouth, lips, oesophagus or skin, and often represents the presence of the underlying cancer.
  • Drug-induced Pemphigus- Pemphigus can occur after taking certain medicines such as some antibiotics and blood pressure medications. For instance, penicillamine is the most common cause of drug-induced pemphigus.

Symptoms can vary based on the type of pemphigus the patient has but could include blisters or sores that leak clear fluid or may bleed lightly, fluid-filled bubble or blister on the skin, sores with a crusty appearance, itchy skin, and more. Pemphigus vulgaris can lead to other problems, such as blisters and sore patches that can cause life-threatening problems such as sepsis, weight loss and malnutrition, tooth decay and gum disease. Some of the severe symptoms of this condition are fever, fatigue, muscle weakness, vision problems and light sensitivity.

Pemphigus – ICD-10 Codes

  • L10 Pemphigus
  • L10.0 Pemphigus vulgaris
  • L10.1 Pemphigus vegetans
  • L10.2 Pemphigus foliaceous
  • L10.3 Brazilian pemphigus [fogo selvagem]
  • L10.4 Pemphigus erythematosus
  • L10.5 Drug-induced pemphigus
  • L10.8 Other pemphigus
    • L10.81 Paraneoplastic pemphigus
    • L10.89 Other pemphigus
  • L10.9 Pemphigus, unspecified

Diagnostic procedures for pemphigus may include a physical examination of skin blisters as well as special testing and clinical presentation such as lesion biopsy, direct immunofluorescence, indirect immunofluorescence or an antibody titer test.

CPT Codes to Report Lesion Biopsy

  • 11102 Tangential biopsy of skin (e.g., shave, scoop, saucerize, curette) single lesion
  • 11104 Punch biopsy of skin (including simple closure, when performed) single lesion
  • 11106 Incisional biopsy of skin (e.g., wedge) (including simple closure, when performed) single lesion

Though there is no cure for pemphigus or pemphigoid, the signs and symptoms can be controlled mainly using corticosteroids (prednisone, an anti-inflammatory medication to suppress the normal function of the immune system), steroids (topical or systemic steroids), Rituximab (FDA-approved first-line therapy), plasmapheresis or intravenous immunoglobulin therapy (IVIG). Other medications that may be prescribed to suppress the immune system include azathioprine, mycophenolate mofetil, methotrexate, and cyclophosphamide.

Accurate and efficient medical billing and coding is essential for any dermatology practice to receive maximum reimbursement for the services provided. By outsourcing the tasks to a reputable dermatology medical coding company that provides the services of AAPC-certified coding specialists, dermatology practices can ensure correct and timely medical billing and claims submission.

What Are the Codes to Report Supernumerary Teeth?

What Are the Codes to Report Supernumerary Teeth?

Supernumerary teeth refers to a common dental condition wherein extra teeth grow inside the mouth. Also called hyperdontia, these extra teeth can grow anywhere in the curved areas (dental arches) where teeth attach to the jaw line. The prevalence of this dental condition is twice as common in adult males than in adult females. In fact, the majority of cases of supernumerary teeth appear as a single tooth, but sometimes multiple teeth are present, appearing separately or in clusters. The exact factors that cause this dental condition are not fully known. However, researchers say that a combination of several hereditary factors and birth defects can contribute to this condition. Billing and coding for this specific dental condition can be challenging. Reliable dental billing services provided by AAPC-certified coding specialists can help in accurate and timely billing and claims submission.

Symptoms of Supernumerary Teeth

As mentioned above, supernumerary teeth can appear anywhere in the mouth and are mostly found among the permanent teeth. However, they also occur among baby teeth, but tend to be harder to identify, as they often erupt normally, are shaped like other teeth, and are in correct alignment. This dental condition is classified by way of shape and by way of location. The sudden growth of extra teeth directly behind or close to the usual primary or permanent teeth is one of the primary symptoms of this dental disorder. The extra teeth can appear in anyone but are more often associated with people who have Gardner’s syndrome (a rare genetic disorder), Down syndrome, Ehlers-Danlos syndrome, Cleidocranial dysplasia, Fabry disease and those born with a cleft lip and palate.

Generally, the condition isn’t painful. However, in certain cases, it can put extra pressure on the jaw and gum lines, making them swollen and painful. If not treated properly, a variety of dental problems may develop, such as – tooth impaction, crowding, displacement, and misalignment of normal permanent teeth, premature closure of spaces in between the teeth, formation of oral cysts or tumors, eruption of teeth into the nasal cavity and issues with proper chewing. Overcrowding caused by this condition can make permanent teeth look crooked.

Diagnosing and Treating Supernumerary Teeth

Diagnosis of this dental disorder is quite easy if the extra teeth have already grown. However, if they have not grown in fully, diagnosing can be quite difficult. In such cases, imaging tests such as – dental X-rays and CT scans may be performed for a more detailed analysis of the mouth, jaw, and teeth. Certain cases of hyperdontia do not require any specific treatment, while other cases involve removing the extra teeth. For instance, if the extra teeth is affecting a person’s dental hygiene or causing other problems such as – chewing problems, pain or discomfort while brushing /flossing teeth, or delaying the eruption of permanent teeth, it is better to remove them.

Treatment for this dental disorder depends on the type and position of the supernumerary teeth and how it affects the adjacent teeth. If the extra teeth cause only mild discomfort, the dentist may recommend non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) for pain. Other treatment modalities include – removal of the teeth when possible (performed under local or general anesthesia). In certain other cases, supernumerary teeth may need to be cut and then removed in pieces. Endodontic treatment (also known as a root canal) may also be done to treat the tooth pulp as well as surrounding tissues.

ICD-10 Codes for Supernumerary Teeth

The treatment modalities and other screening tests performed by dentists, orthodontists, and other dental specialists must be carefully documented using the correct medical codes. Billing and coding services provided by an established medical billing and coding company can help physicians use the correct codes for their billing purposes. ICD-10 codes for supernumerary teeth include –

  • K00 Disorders of tooth development and eruption
  • K00.0 Anodontia
  • K00.1 Supernumerary teeth
  • K00.2 Abnormalities of size and form of teeth
  • K00.3 Mottled teeth
  • K00.4 Disturbances in tooth formation
  • K00.5 Hereditary disturbances in tooth structure, not elsewhere classified
  • K00.6 Disturbances in tooth eruption
  • K00.7 Teething syndrome
  • K00.8 Other disorders of tooth development
  • K00.9 Disorder of tooth development, unspecified

As mentioned above, most cases of supernumerary teeth do not require any specific treatment. In other cases, patients need to remove some or all of their extra teeth to avoid further problems. It is not necessary to remove natal teeth unless the supernumerary teeth are loose and present a risk for aspiration due to passage into the lung.

What Are the ICD-10 Codes for Hyperlipidemia?

What Are the ICD-10 Codes for Hyperlipidemia?

Hyperlipidemia (also called high cholesterol) refers to elevated levels of fats (lipids such as cholesterol and triglycerides) in the blood. Generally, our body requires adequate amounts of fats to build healthy cells. However, high levels of cholesterol can result in fatty deposits in the blood vessels, which in turn may result in blockage of the free flow of blood through the arteries.

About 94 million people over age 20 are estimated to have elevated total cholesterol levels. This amounts to about 50 percent of all U.S. adults. If left undiagnosed or untreated, the clogged arteries can trigger heart attack, stroke, or lead to other serious problems. People with untreated hyperlipidemia are twice as likely to develop coronary artery disease (CAD) as those with cholesterol levels in the normal range. Although high cholesterol levels can be inherited, it is most often the result of lifestyle factors like an unbalanced diet and reduced physical activity.

Therefore, incorporating key lifestyle and dietary options can help treat and prevent hyperlipidemia in an effective manner. Billing and coding for this condition is challenging due to the complexity of the codes and other related terminologies. Medical billing and coding companies can accurately assign the medical codes and ensure timely submission of your medical claims.

Symptoms of Hyperlipidemia

Generally, people with hyperlipidemia do not experience any specific symptoms until the condition has reached an advanced stage when people experience emergency complications, such as a heart attack or stroke. However, those with familial, or inherited hyperlipidemia, may develop certain symptoms such as – yellow, fatty growths around the eyes or joints.

Diagnosis involves a blood test called a lipid panel or a lipid profile. The physician will use the lipid panel to make a hyperlipidemia diagnosis. The Centers for Disease Control and Prevention (CDC) recommends that every person get a cholesterol test starting at the age of 20. In certain cases, cholesterol test may be appropriate for children and adolescents.

The CDC points out that 1 in 5 adolescents have high cholesterol in the United States. Physicians will recommend a cholesterol test for a child – if their family has a history of early heart attacks or heart disease, if a child has excess weight/obesity or diabetes. Incorporating key lifestyle changes is the first line of treatment for hyperlipidemia. Key lifestyle changes include – consuming a heart-healthy diet, doing regular exercise, quitting the habit of smoking, and maintaining a healthy body weight. In certain cases, if changes do not reduce the cholesterol levels, physicians may prescribe medications.

ICD-10 Codes for Hyperlipidemia

  • E78 Disorders of lipoprotein metabolism and other lipidemias
  • E78.0 Pure hypercholesterolemia
  • E78.00 Pure hypercholesterolemia, unspecified
  • E78.01 Familial hypercholesterolemia
  • E78.1 Pure hyperglyceridemia
  • E78.2 Mixed hyperlipidemia
  • E78.3 Hyperchylomicronemia
  • E78.4 Other hyperlipidemia
  • E78.41 Elevated Lipoprotein (a)
  • E78.49 Other hyperlipidemia
  • E78.5 Hyperlipidemia, unspecified
  • E78.6 Lipoprotein deficiency
  • E78.7 Disorders of bile acid and cholesterol metabolism
  • E78.70 Disorder of bile acid and cholesterol metabolism, unspecified
  • E78.71 Barth syndrome
  • E78.72 Smith-Lemli-Opitz syndrome
  • E78.79 Other disorders of bile acid and cholesterol metabolism
  • E78.8 Other disorders of lipoprotein metabolism
  • E78.81 Lipoid dermatoarthritis
  • E78.89 Other lipoprotein metabolism disorders
  • E78.9 Disorder of lipoprotein metabolism, unspecified

Hyperlipidemia is treatable and complications can often be avoided. Heart-healthy lifestyle changes can reduce cholesterol levels in the long run. Regular physical activity combined with a healthy diet can improve the balance of cholesterol in the blood and thereby prevent related health problems.

Healthcare providers need to be well-informed about the specific ICD-10 codes to report hyperlipidemia. Medical billing outsourcing services provided by AAPC-certified coders can help physicians optimize reimbursement for the services they offer.

Common Dental Problems During Summer and Their Codes

Common Dental Problems During Summer and Their Codes

Summer is the time for sunshine, vacation and camping out. However, the hot weather can your teeth and gums as well, increasing the visits to dentists and oral hygienists. Treatment for dental issues varies depending on the severity and the type of injury. Treatments can include dental implants, corrective jaw surgery, root canals, bone grafting, cosmetic surgery, and more. While ensuring to provide excellent patient care, dental practices should also manage submitting clean claims to insurers, for on-time reimbursement. Dental billing services from a professional billing company can help providers with accurate and timely claim filing.

Causes of Problems During Summer

Teeth problems can arise during the sunny season, due to many reasons such as –

Extreme heat

During warm weather, the bacteria present in decayed tooth can cause chronic inflammation around the tooth in tissue, which lead to severe toothache. The hot weather activate untreated infection in a tooth.

Sugary acids in soft drinks

Consuming sugary or fizzy carbonated drinks can lead to tooth decay, cavities and acid erosion of the teeth. Such as excessive sugary and acidic components that are harmful to the teeth. Sugar can worsen tooth sensitivity and cause toothache or gum sores.


Increased body temperature due to heat can cause dehydration. Chronic dehydration can impact oral health, as low salivation levels will dry out the teeth and gums, resulting in various dental diseases.

Risk of injuries the teeth

Summer fun activities such as swimming, bike riding, sports, and other playground activities c dental injuries. The teeth cracked or broken when an individual slips and falls on a hard surface, such as a wet floor. Fractures can also occur. Some of the most common dental injuries after a slip and fall include avulsed teeth, fractured teeth, and tooth luxation.

ICD-10 Codes to Report Summer Dental Diseases

Dental cavities

  • K02 Dental caries
    • K02.3 Arrested dental caries
    • K02.5 Dental caries on pit and fissure surface
      • K02.51 …… limited to enamel
      • K02.52 …… penetrating into dentin
      • K02.53 …… penetrating into pulp
    • K02.6 Dental caries on smooth surface
      • K02.61 …… limited to enamel
      • K02.62 …… penetrating into dentin
      • K02.63 …… penetrating into pulp
    • K02.7 Dental root caries
    • K02.9 Dental caries, unspecified

Dental sensitivity

  • K03.89 Other specified diseases of hard tissues of teeth
  • K03.9 Disease of hard tissues of teeth, unspecified

Dental trauma

  • K08.41 Partial loss of teeth due to trauma
    • K08.411 …… class I
    • K08.412 …… class II
    • K08.413 …… class III
    • K08.414 …… class IV
    • K08.419 …… unspecified class

Dental erosion

  • K03.2 Erosion of teeth

Gum disease

  • K05.5 Other periodontal diseases
  • K05.6 Periodontal disease, unspecified

Teeth discoloration

  • K03.7 Posteruptive color changes of dental hard tissues

Avulsed teeth

  • S03.2 Dislocation of tooth
    • S03.2XXA …… initial encounter
    • S03.2XXD …… subsequent encounter
    • S03.2XXS …… sequela

Fractured teeth

  • S02.5 Fracture of tooth (traumatic)
    • S02.5XXA …… initial encounter for closed fracture
    • S02.5XXB …… initial encounter for open fracture
    • S02.5XXD …… subsequent encounter for fracture with routine healing
    • S02.5XXG …… subsequent encounter for fracture with delayed healing
    • S02.5XXK …… subsequent encounter for fracture with nonunion
    • S02.5XXS …… sequela

Broken jaw

  • K03. 81 Cracked tooth

Patient eligibility checks and authorizations are imperative to give both the patient and the dentist the financial breakdown of the patient’s portion, the insurance’s portion, and the probable write-off amount. Proper dental insurance verification is crucial for practices to ensure that the patient has coverage for the treatments being provided. Practices can consider choosing a reliable dental billing company to handle all of their dental insurance verification needs.

What Is the Correct Code to Report Rheumatic Fever?

What Is the Correct Code to Report Rheumatic Fever?

Rheumatic fever is an autoimmune disease that causes inflammation in the body’s tissues. Also called acute rheumatic fever, this condition causes the body’s immune system to attack its own tissues, causing inflammation (swelling). Rheumatic fever disease develops as a rare complication when the body’s immune system overreacts to a strep throat or scarlet fever infection (caused by an infection with streptococcus bacteria) that goes untreated. If left untreated, rheumatic fever can cause permanent damage to the heart – including damaged heat valves and heart failure.

Assigning the correct medical codes on the medical claims can be challenging as there are several codes and coding guidelines on how to report rheumatic fever. Partnering with a reputable medical coding service provider can ensure correct coding and efficient claims management for optimal reimbursement.

Rheumatic fever may affect the joints, heart, blood vessels, brain and skin. Anyone can get affected by rheumatic fever. But, it most commonly appears in children in the age group of 5 – 15. However, younger children and older adults can contract the illness as well.

Most people who get strep throat or scarlet fever don’t develop rheumatic fever. It only occurs when these conditions don’t get properly treated. When people get rheumatic fever, it usually develops two to three weeks after an untreated strep throat or scarlet fever.

Symptoms of Rheumatic Fever

Rheumatic fever can affect people in different ways. Signs and symptoms of the condition can vary widely, depending on what part of the body the disease impacts. There may be few symptoms or several, and these can change during the course of the disease.

In certain cases, people experience very mild strep symptoms that they don’t realize they had a strep infection until rheumatic fever develops later on. The onset of rheumatic fever generally occurs about 2 to 4 weeks after a strep throat infection. Common symptoms include –

  • Fever
  • Swollen, tender and red joints (particularly in the large joints such as the knees, ankles, wrists and elbows)
  • Unexplained or ongoing headaches
  • Chest pain and abnormal heart beat
  • Fatigue
  • Flat or slightly raised, painless rash with a ragged edge
  • Heart murmur
  • Jerky, uncontrollable body movements (most often in the hands, feet and face)
  • Small, painless bumps beneath the skin

Several factors like – genes, environmental factors, age, and overall health of the patient tend to increase the risk of this condition in the long run.

How to Diagnose Rheumatic Fever

There is no test for diagnosing rheumatic fever. Diagnosis of this condition is based on a detailed medical history evaluation, physical examination and certain test results. Physical examination may be performed to look for a rash or skin nodules, check heart abnormalities and examine the joints for inflammation. Movement tests may also be performed to identify nervous system dysfunction. Blood tests may be performed to check for signs (markers) of inflammation in the blood.Other tests include – electrocardiogram (ECG or EKG) and echocardiogram.

Treatment for rheumatic fever will focus on treating the infections, relieving symptoms and controlling inflammation. Common treatment modalities include – antibiotics, anti-inflammatory medications and anti-seizure drugs. Physicians will also recommend bed rest and restricted activities until the major symptoms like pain and inflammation have passed. In case the fever has caused heart problems, strict bed rest will be recommended for a few weeks or months.

ICD-10 Codes to Report Rheumatic Fever

Physicians treating patients with rheumatic fever need to document the treatment administered using the right medical codes. Partnering with a reputable medical billing and coding company can ensure accurate claim submission. Here are the ICD-10 codes for a rheumatic fever diagnosis –

  • I00 Rheumatic fever without heart involvement
  • I01 Rheumatic fever with heart involvement
    • I01.0 Acute rheumatic pericarditis
    • I01.1 Acute rheumatic endocarditis
    • I01.2 Acute rheumatic myocarditis
    • I01.8 Other acute rheumatic heart disease
    • I01.9 Acute rheumatic heart disease, unspecified

One of the most effective ways to prevent rheumatic fever is to start treating strep throat infections or scarlet fever promptly within several days of contracting the infections. In addition, practicing proper hygiene habits like – covering the mouth (when coughing or sneezing), avoiding contact with sick people and washing hands can help prevent the occurrence of strep throat infections.

Billing and coding for rheumatic fever can be complex. For accurate and timely billing and claims submission, physician practices can rely on the services of reputable medical billing and coding outsourcing companies that provide the services of AAPC-certified coding specialists.

What Are the Medical Codes to Report Epilepsy?

What Are the Medical Codes to Report Epilepsy?

According to oxhp.com, epilepsy is commonly found and 10% of Americans have at least one seizure in their lifetime. This neurological condition is characterized by two or more unprovoked seizures. Seizures are unpredictable and it is difficult for health care providers to diagnose epilepsy. Neurologists are required to carefully understand the medical history of the patient and assess brain imaging results to analyze the abnormal patterns of electrical activity in the brain. It is essential to have specificity in the diagnosis for delivering excellent patient care and for accurate clinical documentation. Medical billing services can ensure that appropriate ICD-10 codes and CPT codes are compiled based on the clinical documentation.

CPT Codes To Report Epilepsy Treatment Procedures

The severity of the disease and its outcome have to be examined by neurologists to determine the treatment plan. Excellent patient care can be delivered only with accurate diagnosis. The CPT codes corresponding to each procedure have to be accurately assigned for successful reimbursement of the claims.

  • 95819- Routine EEG (Electroencephalogram)

Electroencephalogram or EEG is a diagnostic test that uses small electrodes attached to the scalp to measure the electrical activity of the brain. In this procedure, the provider performs the EEG during awake and asleep states of the patient.

  • 95709- Long-term EEG monitoring

The patient undergoes an electroencephalography, a study of the electrical activity of the brain, lasting 12 to 26 hours with intermittent monitoring and maintenance. No video recording is made, and an EEG technologist reviews the data and writes a technical description.

  • 70554 – MRI procedures of the Head and Neck

The provider performs a functional magnetic resonance imaging (fMRI) of the brain, which tracks brain activity by assessing the metabolic changes that occur in response to neural activity.

  • 78811-Positron Emission Tomography (PET)

In this diagnostic procedure, the provider performs PET, positron emission tomography, on a small, defined area of the body. PET is a type of nuclear imaging test that produces three-dimensional images of functional processes in the body, and is an effective method of detecting tumor cells in the body.

ICD-10 Codes to Report Epilepsy

The ICD-10 codes for epilepsy are mentioned under G00-G99 Diseases of the nervous system, G40-G47 Episodic and paroxysmal disorders.

  • G40- Epilepsy
    • G40.11: Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures or localized onset, intractable, with status epilepticus.
    • G40.019: Localization-related (focal) (partial) idiopathic epilepsy and epileptic syndromes with seizures of localized onset, intractable, without status epilepticus.
    • G40.111: Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, with status epilepticus.
    • G40.119: Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with simple partial seizures, intractable, without status epilepticus.
    • G40.211: Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizure, intractable, with status epilepticus.
    • G40.219: Localization-related (focal) (partial) symptomatic epilepsy and epileptic syndromes with complex partial seizures, intractable, without status epilepticus.
    • G40.3: Generalized idiopathic epilepsy and epileptic syndrome
    • G40.4: Other generalized epilepsy and epileptic syndromes
    • G40.5: Special epileptic syndromes
    • G40.6: Grand mal seizures, unspecified (with or without petit mal)
    • G40.7: Petit mal, unspecified, without grand mal seizures
    • G40.8: Other epilepsy
    • G40.9: Epilepsy, unspecified
  • G41: Status epilepticus
    • G41.0: Grand mal status epilepticus
    • G41.1: Petit mal status epilepticus
    • G41.2: Complex partial status epilepticus
    • G41.8: Other status epilepticus
    • G41.9: Status epilepticus, unspecified

Accurate neurology medical billing is essential for prompt reimbursement of medical claims. An expert team of coders can appropriately assign codes, eliminating the chances of claim denials.