May 8, 2018

Sexually Transmitted Disease Awareness

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CMS encourages providers to talk, test, and treat STDs.

When it comes to sexually transmitted disease (STD) awareness, the Centers for Medicare & Medicaid Services (CMS) is encouraging providers to take three simple steps in protecting their patients through talk, testing, and treating:

  1. Talk openly about STDs with your partners and healthcare providers.

  2. Get tested: it’s the only way to know if you have an STD.

  3. Treat, if you have an STD, and work with your provider to get the right medicine.

The Centers for Disease Control and Prevention (CDC) has also published information indicating that STDs are at an all-time high. In 2017 there were:

  • 1.59 million chlamydia cases (up 4.7 percent since 2015)

  • 468,514 gonorrhea cases (up 18.5 percent since 2015)

  • 27,814 syphilis cases (up 17.6 percent since 2015)

Anyone who has sex is at risk for STDs, but the following groups are more affected:

  1. Young people ages 15-24

  2. Gay and bisexual men

  3. Pregnant women

Most STDs affect both men and women, but in many cases the health problems they cause can be more severe for women. If a pregnant woman has an STD, it can cause serious health problems for the baby.

CMS recommends appropriate Medicare-covered preventive services be utilized, including:

  • Screening for sexually transmitted infections (STIs) and high-intensity behavioral counseling to prevent STIs  

  • Human immunodeficiency virus (HIV) screening

  • Hepatitis B virus vaccine administration

You will find the diagnosis codes for sexually transmitted diseases in Chapter 1: Infectious and Parasitic Diseases, with the code category block A50-A64 covering infections with a predominantly sexual mode of transmission. There a Type 1 Excludes note listed also:

  • Human immunodeficiency virus (HIV) disease (B20)

  • Nonspecific and nongonococcal urethritis (N34.1)

  • Reiter's disease (M02.3-)

In looking at the Tabular list of Code Blocks, the following can be found:

A50   Congenital syphilis
 
A51   Early syphilis
 
A52   Late syphilis
 
A53   Other and unspecified syphilis
 
A54   Gonococcal infection
 
A55   Chlamydial lymphogranuloma (venereum)
 
A56   Other sexually transmitted chlamydial diseases
 
A57   Chancroid
 
A58   Granuloma inguinale
 
A59   Trichomoniasis
 
A60   Anogenital herpesviral (herpes simplex) infections
 
A63   Other predominantly sexually transmitted diseases, not elsewhere classified
 
A64   Unspecified sexually transmitted disease
 

Another code that may be helpful to be aware of is Z11.3, Encounter for screening for infections with a predominantly sexual mode of transmission.

There are no chapter 1-specific guidelines regarding the code range A50-A64. However, all coding professionals should be reading through the American Hospital Association (AHA) Coding Clinic on ICD-10-CM to receive additional guidance on the coding of sexually transmitted diseases that may have been published. 

Striving for coding accuracy, integrity, and compliance always requires a complete understanding of the disease process, plus the Official Guidelines for Coding and Reporting.


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Gloryanne Bryant, RHIA, CDIP, CCS, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer

Gloryanne is a coding and HIM professional with 40 years of experience. She is the past president of the California Health Information Association. Gloryanne is a member of the ICD10monitor editor board and is a popular guest on Talk Ten Tuesdays.

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