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v1.0.0
ICD-10 Guide
ICD-10 CodesA51.5

A51.5

Late congenital syphilis, symptomatic

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A51.5 is a billable code used to indicate a diagnosis of late congenital syphilis, symptomatic.

Key Diagnostic Point:

Late congenital syphilis is a manifestation of syphilis that occurs in infants who were infected in utero. This condition can present with a variety of symptoms, including but not limited to bone deformities, neurological deficits, and skin rashes. Symptoms may not appear until later in childhood, making diagnosis challenging. The clinical manifestations can include Hutchinson's teeth, saddle nose deformity, and keratitis. Late congenital syphilis can lead to significant morbidity if not diagnosed and treated promptly. The condition is a result of the Treponema pallidum bacterium, which can cross the placental barrier during pregnancy. Early detection and treatment of syphilis in pregnant women are crucial to prevent congenital syphilis. Treatment typically involves the administration of penicillin, which is effective in eradicating the infection. Regular follow-up and monitoring are essential to assess the effectiveness of treatment and to manage any long-term complications that may arise.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between late congenital syphilis and other forms of syphilis.
  • Understanding the timing of symptom onset and its implications for coding.
  • Need for comprehensive documentation of clinical findings.
  • Potential for co-morbid conditions that may complicate coding.

Audit Risk Factors

  • Inadequate documentation of maternal syphilis status.
  • Failure to document specific symptoms associated with late congenital syphilis.
  • Misclassification of the stage of syphilis.
  • Inconsistent coding of related conditions.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed clinical notes on symptoms, family history, and maternal health.

Common Clinical Scenarios

Infants presenting with developmental delays or unusual physical findings.

Billing Considerations

Consideration of maternal syphilis screening and treatment history.

Obstetrics

Documentation Requirements

Thorough documentation of prenatal care, syphilis screening results, and treatment provided.

Common Clinical Scenarios

Pregnant women diagnosed with syphilis and their management.

Billing Considerations

Importance of timely treatment to prevent transmission to the fetus.

Coding Guidelines

Inclusion Criteria

Use A51.5 When
  • According to ICD
  • 10 guidelines, A51
  • 5 should be used when there is clear documentation of symptomatic late congenital syphilis
  • It is important to ensure that the diagnosis is confirmed and that all relevant clinical findings are documented

Exclusion Criteria

Do NOT use A51.5 When
No specific exclusions found.

Related CPT Codes

86592CPT Code

Syphilis serology test

Clinical Scenario

Used for screening pregnant women for syphilis.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Obstetricians should ensure thorough prenatal screening.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of congenital syphilis, improving the accuracy of diagnoses and treatment tracking. A51.5 provides a clear distinction between late and early forms of the disease, which is crucial for appropriate management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of congenital syphilis, improving the accuracy of diagnoses and treatment tracking. A51.5 provides a clear distinction between late and early forms of the disease, which is crucial for appropriate management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of congenital syphilis, improving the accuracy of diagnoses and treatment tracking. A51.5 provides a clear distinction between late and early forms of the disease, which is crucial for appropriate management.

Resources

Clinical References

  • •
    CDC Syphilis Fact Sheet

Coding & Billing References

  • •
    CDC Syphilis Fact Sheet

Frequently Asked Questions

What are the symptoms of late congenital syphilis?

Symptoms can include bone deformities, neurological issues, skin rashes, and dental abnormalities. These symptoms may not appear until later in childhood.