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v1.0.0
ICD-10 Guide
ICD-10 CodesA63

A63

Syphilis

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED08/28/2025

Code Description

ICD-10 A63 is a used to indicate a diagnosis of syphilis.

Key Diagnostic Point:

Sexually transmitted chlamydial infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Standard complexity factors

Audit Risk Factors

  • Standard audit considerations

Specialty Focus

Coding Guidelines

Inclusion Criteria

Use A63 When
  • 10 code A63 is an umbrella code for other viral diseases that are characteristically sexually transmitted, but that can be transmitted via other means as well
  • It is a non
  • billable code, meaning it is not sufficient justification for admission to an acute care hospital when used as a principal diagnosis
  • Guidelines:
  • Inclusion Criteria: It includes diseases such as anogenital (venereal) warts, condyloma acuminatum, molluscum contagiosum, and pelvic inflammatory disease (notably, gonococcal and chlamydial)
  • These include AIDS (B20), herpesviral [herpes simplex] infections (A60), and sexually transmitted chlamydial diseases (A55
  • Code First: If a disease listed under this code has a known causal organism, the infection should be coded first (B95
  • In other words, if the condition is being caused by a specific infection, that infection should be coded before the A63 code

Exclusion Criteria

Do NOT use A63 When
  • Exclusion Criteria: Certain related conditions have their own specific codes and therefore should not be coded under A63
  • It's very important to be familiar with the inclusion and exclusion criteria to avoid such mistakes

Related Codes

Child Codes

2 codes
A63.0
Anogenital (venereal) warts
A63.8
Other specified predominantly sexually transmitted diseases, not elsewhere classified

Related CPT Codes

No CPT Codes Available

Related CPT codes for this diagnosis will be displayed here when available.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

ICD-10 (International Classification of Diseases, Tenth Revision) is a system used by physicians and healthcare providers to classify and code all the diagnoses, symptoms, and medical procedures recorded in conjunction with hospital care in the United States. If we discuss the impact of ICD-10 specifically on coding for A63 (Non-billable), which includes certain conditions associated with sexual transmission, there may not be many significant changes in terms of specificity, reimbursement, and documentation. Here's why:
1. Specificity: ICD-10 is designed to be significantly more specific than its predecessor, ICD-9. This means that while under ICD-9, a disease or condition may only have a few broad codes, under ICD-10, that same condition can have numerous codes to describe it more accurately. However, for A63 (Non-billable) in particular, the specificity may remain the same because it covers a range of conditions that are non-billable and are usually not otherwise specified.
2. Reimbursement: Under ICD-10, healthcare providers typically receive more accurate reimbursements due to increased specificity. However, for A63 (Non-billable), this may not apply since the coding denotes conditions that are typically not eligible for direct reimbursement in the first place.

ICD-9 vs ICD-10

ICD-10 (International Classification of Diseases, Tenth Revision) is a system used by physicians and healthcare providers to classify and code all the diagnoses, symptoms, and medical procedures recorded in conjunction with hospital care in the United States. If we discuss the impact of ICD-10 specifically on coding for A63 (Non-billable), which includes certain conditions associated with sexual transmission, there may not be many significant changes in terms of specificity, reimbursement, and documentation. Here's why: 1. Specificity: ICD-10 is designed to be significantly more specific than its predecessor, ICD-9. This means that while under ICD-9, a disease or condition may only have a few broad codes, under ICD-10, that same condition can have numerous codes to describe it more accurately. However, for A63 (Non-billable) in particular, the specificity may remain the same because it covers a range of conditions that are non-billable and are usually not otherwise specified. 2. Reimbursement: Under...

Reimbursement & Billing Impact

reimbursement, and documentation. Here's why:

Resources

Clinical References

No clinical reference resources available for this code.

Coding & Billing References

No coding and billing reference resources available for this code.

Frequently Asked Questions

Q: What does the ICD-10 code A63 stand for?

A: The ICD-10 code A63 refers to "Other predominantly sexually transmitted diseases, not elsewhere classified." This is a non-billable code.

Q: What does it mean when a code like A63 is non-billable?

A: A non-billable code is a high-level term in the code hierarchy under which more specific subcategories fall. It provides a general classification and is not used for claim submission as it's not specific enough.

Q: What are some of the specific conditions that can fall under ICD-10 code A63?

A: There are several specific conditions that fall under the A63 code. They include A63.0 - Anogenital (venereal) warts, A63.8 - Other specified predominantly sexually transmitted diseases, and A63.9 - Sexually transmitted infection, unspecified, among others.

Q: Can I use A63 by itself when submitting insurance claims?

A: No, you cannot. Since A63 is a non-billable or an incomplete code, more specificity is required when submitting insurance claims. You should use one of its subcodes for such instances.

Q: How do I correctly document a condition that falls under code A63?

A: To properly document a condition under the A63 code, you need to provide a more specific description that falls under the A63 categories. For instance, instead of simply stating "sexually transmitted disease," you should specify whether it is "Anogenital warts" (A63.0) or "Other specified predominantly sexually transmitted diseases" (A63.8).

Q: How important is the documentation when billing for conditions under the A63 code?

A: Proper documentation is essential to avoid claim denial or delay in reimbursement. It ensures the delivered healthcare services match the conditions specified in the bill, meaning it proves necessity and appropriateness of service.