Learn about Contact with Tuberculosis Patient (Exposure to TB, TB Contact) diagnosis, including clinical documentation, medical coding, and healthcare guidelines. Find information on TB contact investigation, screening, and preventative treatment options. This resource provides guidance for healthcare professionals on managing and documenting tuberculosis exposure for accurate reporting and patient care.
Also known as
Contact with and exposure to tuberculosis
Indicates contact with a person infected with tuberculosis.
Respiratory tuberculosis
Covers various forms of active respiratory tuberculosis infection.
Observation for suspected tuberculosis
Used for individuals being monitored for potential tuberculosis.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the contact documented as infected?
Yes
Is there active TB disease?
No
Is there evidence of exposure only?
When to use each related code
| Description |
|---|
| Contact with a TB patient. |
| Latent TB infection (LTBI). |
| Active pulmonary tuberculosis. |
Coding lacks specificity regarding the nature of TB contact (e.g., household, occupational). Impacts reimbursement and public health reporting.
Documentation lacks patient's TB status (latent, active). Critical for accurate coding, care planning, and infection control.
Discrepancy between diagnosis and clinical findings or patient history. Requires physician clarification for accurate coding and billing.
Q: What is the recommended protocol for evaluating a healthcare worker with suspected occupational exposure to tuberculosis?
A: Evaluating a healthcare worker with suspected occupational exposure to tuberculosis involves a multi-step process. Initially, a detailed exposure history should be taken, including the nature, duration, and intensity of contact with the index patient. A baseline tuberculin skin test (TST) or interferon-gamma release assay (IGRA) is crucial, even if the healthcare worker has been previously tested. Symptoms suggestive of tuberculosis, such as cough, fever, weight loss, or night sweats, should be meticulously documented. A chest X-ray is indicated if the TST or IGRA is positive or if symptoms are present. If the initial TST or IGRA is negative, repeat testing should be performed 8-10 weeks after the last known exposure to detect seroconversion. Post-exposure prophylaxis (PEP) with isoniazid may be considered based on the risk assessment and guidelines from the Centers for Disease Control and Prevention (CDC). Explore how your institution's occupational health program can assist with managing potential TB exposures.
Q: How do I differentiate between latent tuberculosis infection (LTBI) and active tuberculosis disease in a patient exposed to someone with TB?
A: Differentiating between latent tuberculosis infection (LTBI) and active tuberculosis disease following exposure is critical for appropriate management. LTBI signifies infection without clinical symptoms or radiographic evidence of active disease. Diagnosis is typically made by a positive TST or IGRA in an asymptomatic individual. In contrast, active tuberculosis manifests with clinical symptoms, abnormal chest imaging findings (e.g., infiltrates, cavitations), and positive microbiological confirmation (e.g., sputum smear, culture). Patients with LTBI are not infectious and require treatment to prevent progression to active disease. Active tuberculosis, however, requires prompt initiation of multi-drug therapy to prevent further transmission and complications. Consider implementing a standardized protocol for evaluating individuals exposed to TB to ensure accurate diagnosis and appropriate treatment. Learn more about the CDC guidelines for differentiating LTBI and active TB disease.
Patient presents with a documented exposure to tuberculosis. The contact event occurred on [Date of exposure] with [Relationship to source patient, e.g., family member, coworker]. Source patient has confirmed active pulmonary tuberculosis. Patient reports [Symptoms, e.g., no symptoms, cough, fever, night sweats, weight loss, or specify asymptomatic]. Physical examination reveals [Findings, e.g., clear lung sounds, or specify abnormal findings]. Tuberculin skin test (TST) placed today, results pending. QuantiFERON-TB Gold test ordered. Chest X-ray ordered to evaluate for latent tuberculosis infection (LTBI) or active tuberculosis disease. Patient education provided regarding tuberculosis transmission, prevention, and the importance of follow-up care. Patient advised to return for TST reading in [Number] days. Differential diagnosis includes latent TB infection, active pulmonary TB, and other respiratory infections. ICD-10 code Z20.821 (Contact with and exposure to tuberculosis) assigned. Plan includes further evaluation based on TST and QuantiFERON-TB Gold results, possible initiation of latent tuberculosis treatment if indicated, and public health notification of tuberculosis contact. Follow-up appointment scheduled.