Understanding a positive tuberculin skin test (TST) result postpartum? This resource provides guidance for healthcare professionals on diagnosis, clinical documentation, and medical coding for postpartum patients with positive PPD skin tests. Learn about interpreting induration measurements, differential diagnoses, latent tuberculosis infection (LTBI) treatment considerations during breastfeeding, and relevant ICD-10 codes like A15 and O98. Find information on postpartum tuberculosis screening, management, and reporting requirements.
Also known as
Tuberculosis complicating pregnancy
Positive tuberculin test in postpartum period.
Encounter for screening for TB
Screening for tuberculosis, including postpartum.
Abnormal reaction to tuberculin test
Indicates positive reaction without active TB disease.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is there active pulmonary tuberculosis?
Yes
Code active pulmonary tuberculosis (e.g., A15.0, A15.2, depending on the site and laterality)
No
Is there active extrapulmonary tuberculosis?
When to use each related code
| Description |
|---|
| Postpartum TB Skin Test Positive |
| Latent Tuberculosis Infection |
| Postpartum Active Tuberculosis |
Risk of using non-specific codes like O9A.31 instead of granular codes capturing postpartum status and test type for accurate reimbursement.
Insufficient documentation linking the positive skin test to the postpartum period may lead to coding errors and lost revenue. CDI crucial.
Risk of overlooking codes for latent TB (Z11.0) versus active disease (A15-A19), impacting quality reporting and patient management. Compliance essential.
Postpartum patient presents for evaluation of a positive tuberculin skin test (TST). Patient reports no symptoms of active tuberculosis, such as cough, fever, night sweats, or weight loss. Physical exam reveals a palpable induration of [measurement in millimeters] mm at the TST injection site, placed [number] days prior. Patient's obstetric history is significant for a recent delivery [number] weeks ago. Given the positive TST result, latent tuberculosis infection (LTBI) is suspected. Differential diagnoses include active pulmonary tuberculosis, other mycobacterial infections, and false-positive TST reaction due to prior BCG vaccination. Patient denies history of BCG vaccination. Chest X-ray ordered to rule out active pulmonary TB. QuantiFERON-TB Gold test will be performed to confirm the diagnosis of LTBI. Patient counseling provided regarding the difference between latent and active TB infection. Treatment options for LTBI, including isoniazid, rifampin, and rifapentine, were discussed pending confirmatory testing and assessment for contraindications, particularly considering the postpartum period and breastfeeding status. Patient education provided regarding the importance of adherence to treatment if LTBI is confirmed. Follow-up appointment scheduled to review test results and initiate treatment if indicated. ICD-10 code R74.2 (abnormal reaction to tuberculin skin test) and Z3A.35 (encounter for postpartum care) are considered. CPT codes for the TST administration (86580), chest x-ray (71010), and QuantiFERON-TB Gold test (86481) will be billed accordingly.