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B08.5
ICD-10-CM
Herpangina

Learn about Herpangina diagnosis, including clinical documentation, ICD-10 codes (B08.5), treatment, and patient care. Find information on Herpangina symptoms, causes, coxsackievirus infections, and hand foot and mouth disease differentiation. This resource provides healthcare professionals with essential information for accurate Herpangina medical coding and effective patient management.

Also known as

Vesicular Pharyngitis

Diagnosis Snapshot

Key Facts
  • Definition : Viral infection of the mouth and throat caused by enteroviruses, especially Coxsackievirus A.
  • Clinical Signs : Sudden fever, sore throat, small blisters or ulcers on the back of the mouth and throat.
  • Common Settings : Daycares, schools, summer camps - common in young children during summer and early fall.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC B08.5 Coding
B08.5

Herpangina

Viral infection causing mouth blisters and sore throat.

B00-B09

Viral infections characterized by skin lesions

Infections presenting with skin eruptions caused by viruses.

J00-J99

Diseases of the respiratory system

Conditions affecting the respiratory tract, including infections.

A00-B99

Certain infectious and parasitic diseases

A broad category encompassing various infectious and parasitic illnesses.

Code-Specific Guidance

Decision Tree for

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

Is the diagnosis Herpangina?

  • Yes

    Are there any complications?

  • No

    Do NOT code as Herpangina. Review clinical documentation for alternative diagnosis.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Sudden fever, throat pain, mouth sores.
Fever, sore throat, difficulty swallowing.
Painful blisters in mouth, often with fever.

Documentation Best Practices

Documentation Checklist
  • Herpangina diagnosis documented
  • Patient age noted (crucial for Herpangina)
  • Symptoms: sore throat, fever, mouth blisters
  • Location of oral lesions (anterior palate)
  • Differential diagnosis considered and ruled out

Coding and Audit Risks

Common Risks
  • Unspecified Code Usage

    Using unspecified herpangina codes (e.g., B08.9) when a more specific code is documented, leading to lower reimbursement and inaccurate data.

  • Confusing Herpangina/HFMD

    Miscoding herpangina (B08.5) as hand, foot, and mouth disease (B08.4) or vice versa due to similar symptoms, affecting data integrity.

  • Lacking Supporting Documentation

    Coding herpangina without sufficient clinical documentation to support the diagnosis, increasing audit risk and potential claim denials.

Mitigation Tips

Best Practices
  • Document Coxsackievirus diagnosis for accurate ICD-10 coding (B08.5)
  • Improve CDI: Note ulcer locations (anterior pharynx) for specificity
  • Ensure proper hand hygiene compliance to prevent viral transmission
  • Isolate patients, disinfect surfaces for infection control, avoid sharing utensils
  • Educate patients on symptom management and Herpangina's self-limiting nature

Clinical Decision Support

Checklist
  • 1. Sudden fever, sore throat: check temperature, document throat exam
  • 2. Small oral ulcers/vesicles: note location, size, and count
  • 3. Difficulty swallowing (dysphagia): assess severity, offer fluids
  • 4. Patient age: typically affects children under 5, document age

Reimbursement and Quality Metrics

Impact Summary
  • Herpangina reimbursement: ICD-10 B08.5, optimize coding for maximum payment.
  • Quality metrics impact: Track Herpangina cases for accurate infection control reporting.
  • Coding accuracy crucial: Avoid denials with specific diagnosis codes, not just viral symptoms.
  • Hospital reporting: Monitor Herpangina incidence for public health surveillance and resource allocation.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Herpangina: Code B08.5
  • Document vesicles/ulcers location
  • Check for fever, sore throat codes
  • Exclude HFMD if features differ
  • Consider coxsackievirus lab test code

Documentation Templates

Patient presents with symptoms consistent with herpangina.  Onset of sudden fever, sore throat, and difficulty swallowing was reported within the past [number] days.  Physical examination reveals characteristic small, grayish-white vesicles or ulcers with red halos on the soft palate, tonsils, uvula, and posterior oropharynx.  Differential diagnosis considered hand, foot, and mouth disease, aphthous stomatitis, and viral pharyngitis.  Diagnosis of herpangina is made based on clinical presentation and characteristic oral lesions.  Treatment plan focuses on symptomatic relief, including pain management with over-the-counter analgesics such as ibuprofen or acetaminophen, encouraging fluid intake, and offering popsicles or ice chips to soothe throat discomfort.  Patient education provided on the viral etiology of herpangina, its highly contagious nature, the importance of hand hygiene, and the self-limiting course of the illness, typically resolving within one week.  Follow-up as needed.  ICD-10 code B08.5 confirmed for herpangina.  Medical billing codes will be applied appropriately for evaluation and management services, reflecting the complexity of the visit.
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