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A28.1
ICD-10-CM
Cat Scratch Disease

Learn about Cat Scratch Disease (CSD), also known as Cat Scratch Fever and Bartonella Infection. This resource provides information on diagnosis, treatment, and clinical documentation for healthcare professionals. Find details on ICD-10 codes, medical coding, and best practices for documenting Cat Scratch Disease in patient charts. Understand the symptoms, causes, and management of Bartonella henselae infections for accurate and efficient healthcare documentation.

Also known as

Cat Scratch Fever
Bartonella Infection

Diagnosis Snapshot

Key Facts
  • Definition : Bacterial infection spread by cat scratches or bites.
  • Clinical Signs : Swollen lymph nodes near scratch, fever, fatigue, headache.
  • Common Settings : Exposure to cats, especially kittens.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC A28.1 Coding
A65-A69

Other bacterial diseases

Covers bacterial infections not classified elsewhere, including cat scratch disease.

R59-R59

Other symptoms and signs

May be used for unspecified symptoms related to cat scratch disease like fever or fatigue.

L00-L99

Diseases of the skin and subcutaneous tissue

Relevant for skin manifestations associated with cat scratch disease, such as papules or pustules.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the diagnosis confirmed Cat Scratch Disease?

  • Yes

    Is lymphadenopathy present?

  • No

    Do not code Cat Scratch Disease. Review clinical documentation for alternative diagnosis.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Bacterial infection from cat scratches.
Infection from flea bites, causes fever, headache.
Tick-borne bacterial illness, causes rash, fever, fatigue.

Documentation Best Practices

Documentation Checklist
  • Document exposure to cats/kittens.
  • Record lymphadenopathy location/size.
  • Note presence of papule/pustule at scratch site.
  • Document fever, fatigue, or other symptoms.
  • Consider Bartonella serology/PCR testing results.

Coding and Audit Risks

Common Risks
  • Unspecified Bartonella

    Coding Cat Scratch Disease without specifying the Bartonella species (henselae, quintana) may lead to rejected claims or lower reimbursement.

  • Atypical Presentation

    If clinical findings deviate from typical CSD, documentation must support the diagnosis to avoid coding errors and audit scrutiny.

  • Comorbidity Coding

    Failing to capture relevant comorbidities like lymphadenopathy or ocular manifestations can impact severity and reimbursement.

Mitigation Tips

Best Practices
  • Wash cat scratches immediately. Code A08.1
  • Avoid rough play with cats. Document thoroughly for ICD-10 A68.0
  • Control fleas on pets. SNOMED CT 72967002 for compliance
  • Seek medical care for swollen lymph nodes. Z20.828 ICD-10 encounter code
  • Inform clinicians of cat exposure. ICD-10 Z20.828 improves CDI

Clinical Decision Support

Checklist
  • Hx: Animal scratch/bite, regional lymphadenopathy
  • PE: Papule at inoculation site, swollen lymph nodes
  • Consider Bartonella serology/PCR testing
  • R/O other infections (e.g., lymphoma, tularemia)
  • Document exposure details, lymphadenopathy location

Reimbursement and Quality Metrics

Impact Summary
  • Cat Scratch Disease (CSD) reimbursement hinges on accurate ICD-10 coding (A28.1) and thorough documentation of lymphadenopathy, fever, and exposure to cats. This ensures appropriate payment under various healthcare plans.
  • Misdiagnosis of CSD as other infections can lead to claim denials and revenue loss. Precise coding and clinical validation are crucial for maximizing reimbursement.
  • Accurate CSD diagnosis impacts quality metrics related to infectious disease management. Proper coding facilitates tracking of CSD cases, aiding in epidemiological studies and public health reporting.
  • Timely diagnosis and treatment of CSD reduce complications, positively impacting patient outcomes and minimizing healthcare costs. This enhances quality scores related to patient satisfaction and resource utilization.

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Frequently Asked Questions

Common Questions and Answers

Q: What are the most reliable diagnostic tests for confirming Cat Scratch Disease in pediatric patients with atypical presentations?

A: Diagnosing Cat Scratch Disease (CSD), also known as Cat Scratch Fever or Bartonella Infection, can be challenging, especially in children with atypical presentations. While a thorough history and physical exam, including assessing for regional lymphadenopathy and a history of cat exposure (scratch, bite, or lick), are crucial, they aren't always definitive. Serology, specifically testing for Bartonella henselae antibodies (IgG and IgM), is considered the most common and reliable diagnostic method. Polymerase chain reaction (PCR) testing of lymph node aspirates or biopsies can provide a more definitive diagnosis, especially in cases with unusual presentations or when serology is inconclusive. Consider implementing PCR testing for patients with suspected CSD who present with unusual symptoms or have negative serology. In cases with severe or atypical manifestations, consider consulting with an infectious disease specialist. Explore how advancements in PCR technology are improving CSD diagnosis. Learn more about interpreting serological results for Bartonella henselae.

Q: How do I differentiate Cat Scratch Disease from other causes of lymphadenopathy in a patient with a history of cat exposure?

A: Differentiating Cat Scratch Disease (CSD), or Bartonella Infection, from other causes of lymphadenopathy in patients with cat exposure requires a comprehensive approach. While cat exposure suggests CSD, other conditions like lymphoma, other bacterial infections (e.g., staphylococcal or streptococcal), or even tularemia should be considered. Begin with a detailed history, including the nature of the cat interaction (scratch, bite, or lick), the timing of symptom onset, and any associated symptoms like fever, malaise, or skin lesions. Perform a thorough physical exam, paying close attention to the characteristics of the affected lymph nodes. Laboratory tests play a vital role in differentiation. Serological testing for Bartonella henselae antibodies can be highly suggestive of CSD. If the diagnosis remains uncertain, consider performing a lymph node biopsy or aspirate for PCR analysis to identify the causative organism. Explore how imaging studies can help characterize lymphadenopathy. Consider implementing a diagnostic algorithm for lymphadenopathy to ensure accurate and timely diagnosis.

Quick Tips

Practical Coding Tips
  • Code A08.1 for Cat Scratch Disease
  • Bartonella henselae testing key
  • Document lymphadenopathy location
  • Consider ICD-10 B74.0 if ocular
  • Check for complications, code if present

Documentation Templates

Patient presents with symptoms consistent with cat scratch disease (CSD), also known as cat scratch fever or Bartonella infection.  The patient reports regional lymphadenopathy, most notably in the axillary region, with onset approximately two weeks following a reported cat scratch to the left forearm.  The scratch site itself is healed, with a faintly visible scar noted.  The patient denies fever but reports mild malaise and fatigue.  Differential diagnosis includes other causes of lymphadenopathy such as infectious mononucleosis, lymphoma, and tularemia.  Given the history of cat exposure, characteristic lymphadenopathy, and absence of other systemic symptoms, a presumptive diagnosis of cat scratch disease is made.  Treatment will focus on supportive care, including over-the-counter pain relievers for discomfort related to the enlarged lymph nodes.  Monitoring for potential complications such as Parinaud oculoglandular syndrome or more severe systemic Bartonella infection will be conducted.  Patient education provided regarding cat scratch disease transmission, prevention, and prognosis.  Follow-up appointment scheduled in two weeks to assess lymph node regression.  ICD-10 code A28.1, Bartonellosis, will be used for billing purposes.  This diagnosis is consistent with current clinical guidelines for cat scratch disease management.