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ICD-10 Guide
ICD-10 CodesA56.11

A56.11

Chlamydial female pelvic inflammatory disease

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

Code Description

ICD-10 A56.11 is a billable code used to indicate a diagnosis of chlamydial female pelvic inflammatory disease.

Key Diagnostic Point:

Chlamydial female pelvic inflammatory disease (PID) is an infection of the female reproductive organs caused by the bacterium Chlamydia trachomatis. This condition often arises from untreated chlamydial infections, which are among the most common sexually transmitted infections (STIs) worldwide. PID can lead to serious complications, including chronic pelvic pain, infertility, and ectopic pregnancy. Symptoms may include lower abdominal pain, fever, unusual vaginal discharge, and pain during intercourse. Diagnosis typically involves a combination of clinical evaluation, laboratory testing for chlamydia, and imaging studies to assess the extent of the infection. Treatment usually consists of antibiotics, and it is crucial to treat sexual partners to prevent reinfection. Regular screening for STIs is recommended for sexually active women under 25 and those with risk factors, as early detection and treatment can significantly reduce the risk of complications associated with PID.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between chlamydial PID and other types of PID.
  • Need for accurate documentation of symptoms and laboratory results.
  • Potential for co-infection with other STIs.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of symptoms and clinical findings.
  • Failure to document treatment of sexual partners.
  • Misdiagnosis or lack of confirmation of chlamydial infection.
  • Inconsistent coding of related conditions.

Specialty Focus

Medical Specialties

Gynecology

Documentation Requirements

Detailed patient history, physical examination findings, laboratory results, and treatment plans.

Common Clinical Scenarios

Diagnosis and management of PID, routine STI screenings, and treatment of chlamydial infections.

Billing Considerations

Ensure documentation reflects the severity of the infection and any complications.

Infectious Disease

Documentation Requirements

Comprehensive documentation of diagnostic tests, treatment regimens, and follow-up care.

Common Clinical Scenarios

Management of complex cases of PID with multiple STIs or recurrent infections.

Billing Considerations

Focus on the need for thorough contact tracing and partner management.

Coding Guidelines

Inclusion Criteria

Use A56.11 When
  • According to the official coding guidelines, A56
  • 11 should be used when there is a confirmed diagnosis of chlamydial PID
  • Coders must ensure that documentation supports the diagnosis and treatment provided

Exclusion Criteria

Do NOT use A56.11 When
  • Exclusion criteria include cases where PID is caused by other pathogens

Related CPT Codes

87591CPT Code

Chlamydia trachomatis and Neisseria gonorrhoeae nucleic acid detection

Clinical Scenario

Used when testing for chlamydia in patients with suspected PID.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Gynecologists should ensure comprehensive STI screening.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of chlamydial PID, improving data accuracy and facilitating better tracking of STIs and their complications.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of chlamydial PID, improving data accuracy and facilitating better tracking of STIs and their complications.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of chlamydial PID, improving data accuracy and facilitating better tracking of STIs and their complications.

Resources

Clinical References

  • •
    CDC Sexually Transmitted Diseases Treatment Guidelines

Coding & Billing References

  • •
    CDC Sexually Transmitted Diseases Treatment Guidelines

Frequently Asked Questions

What are the common symptoms of chlamydial PID?

Common symptoms include lower abdominal pain, fever, unusual vaginal discharge, and pain during intercourse. Some women may be asymptomatic.

How is chlamydial PID diagnosed?

Diagnosis is typically made through a combination of clinical evaluation, laboratory testing for chlamydia, and imaging studies such as ultrasound.

What is the treatment for chlamydial PID?

Treatment usually involves antibiotics, and it is essential to treat sexual partners to prevent reinfection.

Why is contact tracing important in chlamydial PID?

Contact tracing helps to identify and treat sexual partners, reducing the risk of reinfection and further transmission of the infection.