ICD-10 Guide

A06.89

Other amebic infections

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/04/2025

Code Description

ICD-10 A06.89 is a billable code used to indicate a diagnosis of other amebic infections.

Key Diagnostic Point:

Other amebic infections

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

# Analysis of ICD-10 Code A06.89 - Other Amebic Infections ## Complexity Rating **Medium** ## Factors Contributing to Complexity 1. **Diverse Etiology**: The term "other amebic infections" encompasses various types of infections caused by different species of amoeba, primarily Entamoeba histolytica but also including other less common species. This diversity can complicate diagnosis and coding. 2. **Clinical Presentation Variability**: Amebic infections can manifest in various forms, such as amoebic dysentery, liver abscesses, or asymptomatic infections. The clinical signs and symptoms may vary widely, making accurate coding dependent on comprehensive clinical evaluation. 3. **Differential Diagnosis**: The need to differentiate between amebic infections and other gastrointestinal or systemic infections requires thorough diagnostic testing. Misdiagnosis can lead to incorrect coding. 4. **Evolving Guidelines**: Coding practices and guidelines for infectious diseases are subject to updates and changes. Keeping abreast of these changes can be complex for coders. 5. **Regional Variability**: The prevalence and types of amebic infections may vary by geographic region, which can affect the documentation and coding practices followed by healthcare providers in different areas. ## Audit Risks and Considerations 1. **Inaccurate Coding**: Due to the broad nature of "other amebic infections," there is a risk of miscoding if the specific type of amebic infection or its effects (e.g., complications) are not clearly documented. 2. **Insufficient Documentation**: Auditors may scrutinize cases where the diagnosis of amebic infection is made without adequate supporting documentation, leading to potential claim denials or recoupments. 3. **Lack of Specificity**: Since A06.89 is a non-specific code, auditors may challenge claims if a more specific diagnosis code could have been applied, especially if the provider fails to document the specific type of amebic infection. 4. **Complications and Comorbidities**: If the patient has other medical conditions that may complicate the amebic infection, it is crucial that these are documented. Failure to do so can lead to inappropriate coding and billing practices. ## Documentation Requirements 1. **Detailed Diagnostic Information**: Documentation must include the specific type of amebic infection, symptoms presented, and results of diagnostic tests (e.g., stool microscopy, serology). 2. **Clinical Notes**: Providers should include clinical notes detailing the patient’s history, findings from physical examinations, and any treatments administered that pertain to the infection. 3. **Treatment Plans**: Documentation should reflect the treatment plan established for the patient, including medications prescribed and the rationale for their use based on the type of amebic infection. 4. **Follow-up Care**: Any follow-up visits or additional tests performed after the initial diagnosis should be documented to ensure continuity of care and support for the ongoing management of the infection. 5. **Complications and Comorbidities**: If applicable, the documentation must address any complications arising from the amebic infection or any comorbidities affecting the patient's overall health status. By understanding the complexity associated with ICD-10 code A06.89 and adhering to thorough documentation practices, healthcare providers can mitigate audit risks and improve the accuracy of coding for amebic infections.

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Standard requirements apply

Common Clinical Scenarios

Various clinical presentations

Billing Considerations

Follow standard billing guidelines

Coding Guidelines

Inclusion Criteria

Use A06.89 When

10 code A06
89 is used to classify "Other amebic infections
" This code is part of the A06 category that covers various amebic infections, primarily caused by the parasite Entamoeba histolytica
Below are comprehensive coding guidelines for A06
When to Use A06
Related Codes
89 is specifically used when a patient is diagnosed with an amebic infection that is not classified under more specific codes for well
known conditions like amebic dysentery (A06

Exclusion Criteria

Do NOT use A06.89 When

89, including when to use this code, related codes, specificity requirements, inclusion and exclusion criteria, common coding errors, and considerations for principal diagnosis
Inclusion and Exclusion Criteria
Exclusion Criteria:
Exclude A06

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

Changes from ICD-9 to ICD-10

1. Code Structure: In ICD-9, amebic infections were generally coded under 006.9 (Amebic infection, unspecified). The transition to ICD-10 introduced a more nuanced classification, allowing for the specification of different types of amebic infections, including A06.89 for "Other amebic infections." This transition enhanced the granularity of the coding system, reflecting more accurate disease classification.

ICD-9 vs ICD-10

The implementation of ICD-10 had a significant impact on the coding of various diseases, including amebic infections, particularly code A06.89, which refers to "Other amebic infections." Below is a detailed analysis of the changes and implications associated with this specific code. Changes from ICD-9 to ICD-10 1. Code Structure: In ICD-9, amebic infections were generally coded under 006.9 (Amebic infection, unspecified). The transition to ICD-10 introduced a more nuanced classification, allowing for the specification of different types of amebic infections, including A06.89 for "Other amebic infections." This transition enhanced the granularity of the coding system, reflecting more accurate disease classification. 2. Additional Codes: ICD-10 contains additional codes that can provide more detailed descriptions of the condition, allowing coders to specify the type of amebic infection more precisely than was possible in ICD-9. Specificity Improvements - Increased Detail: ICD-10 allows for more specific coding that can differentiate between types of amebic...

Reimbursement & Billing Impact

Reimbursement Implications - Accuracy in Billing: The increased specificity can lead to more appropriate reimbursement. Payers often require precise coding to justify payments, and the enhanced detail in ICD-10 can support more accurate claims. This can lead to reduced claim denials and improved revenue cycle management.

A06.89

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions

A06.89

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions