ICD-10 Code A18.4 | Tuberculosis of skin and subcutaneous tissue Symptoms, Diagnosis, Billing

Tuberculosis of skin and subcutaneous tissue is a rare manifestation of tuberculosis, primarily caused by Mycobacterium tuberculosis. It can lead to significant morbidity if not diagnosed and treated promptly. The ICD-10 Code A18.4 facilitates accurate diagnosis, documentation, medical billing, and public health reporting, ensuring that healthcare providers can effectively track and manage this condition.

What is ICD-10 Code A18.4 for Tuberculosis of skin and subcutaneous tissue?

ICD-10 Code A18.4 represents Tuberculosis of skin and subcutaneous tissue, a localized form of tuberculosis that affects the dermal and subcutaneous layers. This code should be used when documenting cases where the skin or subcutaneous tissue is involved, often as a complication of systemic tuberculosis, ensuring proper billing and clinical management.

ICD-10 Code A18.4 – Clinical Definition and Explanation of Tuberculosis of skin and subcutaneous tissue

Tuberculosis of skin and subcutaneous tissue is caused by the hematogenous spread of Mycobacterium tuberculosis, often presenting as nodules or ulcers. It requires prompt medical attention to prevent further complications and systemic spread. Early diagnosis is crucial for effective treatment.

Key Clinical Features:

• Presence of painful nodules or ulcers on the skin.
• History of pulmonary or extrapulmonary tuberculosis.
• Possible systemic symptoms such as fever and weight loss.
• Skin lesions may be mistaken for other dermatological conditions.

ICD-10 Code A18.4 for Tuberculosis of skin and subcutaneous tissue – SOAP Notes & Clinical Use

ICD-10 Code A18.4 is utilized in SOAP notes to document the patient's symptoms, assessment findings, and treatment plans. It is relevant in both acute and chronic care settings, ensuring comprehensive documentation of the condition's management.

What Does ICD-10 Code A18.4 for Tuberculosis of skin and subcutaneous tissue Mean in SOAP Notes?

In SOAP notes, ICD-10 Code A18.4 connects subjective patient-reported symptoms and objective clinical findings to a formal diagnosis of tuberculosis affecting the skin. This ensures continuity of care, supports accurate billing, and meets EHR documentation standards.

Treatment Options for ICD-10 Code A18.4 – Tuberculosis of skin and subcutaneous tissue

Tuberculosis of skin and subcutaneous tissue requires urgent medical intervention, often necessitating hospitalization for effective management.

Antibiotic Therapy:

• First-line: Rifampicin and Isoniazid for 6-12 months.
• Alternative: Ethambutol or Pyrazinamide if resistance is suspected.
• Consideration of second-line agents for resistant cases.

Supportive Care:

• Wound care for skin lesions to prevent secondary infections.
• Pain management as needed.
• Nutritional support to enhance recovery.

Infection Control:

• Implement standard precautions to prevent transmission.
• Isolation of patients with active pulmonary tuberculosis.
• Monitoring for outbreaks in healthcare settings.

How to Document Symptoms of Tuberculosis of skin and subcutaneous tissue (ICD-10 A18.4) in SOAP Notes

Subjective:

• Patient reports painful skin lesions with associated itching.
• History of recent weight loss and night sweats.
• Previous diagnosis of pulmonary tuberculosis.
• Family history of tuberculosis.

Objective:

• Physical examination reveals multiple nodular lesions on the forearm.
• Temperature: 100.5°F, indicating possible systemic involvement.
• Skin biopsy shows caseating granulomas.
• Chest X-ray shows no active pulmonary disease.

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SOAP Note Guidelines for Diagnosing Tuberculosis of skin and subcutaneous tissue (ICD-10 Code A18.4)

Assessment:

• Diagnosis: Tuberculosis of skin and subcutaneous tissue, moderate severity.
• ICD-10 Code: A18.4.
• Contributing factors: History of pulmonary tuberculosis.
• Consideration of immunocompromised status.

Plan:

• Initiate treatment with Rifampicin and Isoniazid.
• Educate patient on medication adherence and potential side effects.
• Schedule follow-up in 4 weeks to assess treatment response.
• Monitor for any signs of systemic spread.

Treatment & Plan Section for ICD-10 Code A18.4 – Tuberculosis of skin and subcutaneous tissue

• First-line pharmacologic treatments include Rifampicin and Isoniazid.
• Non-pharmacologic strategies involve patient education on tuberculosis transmission.
• Monitoring includes regular follow-up appointments and skin assessments.
• Follow-up practices should include chest X-rays to rule out pulmonary involvement.

Using ICD-10 Code A18.4 for Tuberculosis of skin and subcutaneous tissue in Billing & SOAP Note Compliance

• Select appropriate ICD-10 codes based on clinical findings and severity.
• Document symptoms clearly under Subjective (S) and Objective (O) in SOAP notes.
• Ensure treatment plans align with clinical guidelines to support justified billing.
• Include relevant CPT codes that correspond with the services provided.

Related ICD-10 Codes Often Used with Tuberculosis of skin and subcutaneous tissue

• A15.0 – Pulmonary tuberculosis, bacteriologically and histologically confirmed
• A18.0 – Tuberculosis of bones and joints
• A18.2 – Tuberculosis of the central nervous system
• A19.9 – Miliary tuberculosis, unspecified

ICD-10 Code A18.4 in Medical Billing and Insurance for Tuberculosis of skin and subcutaneous tissue

ICD-10 Code A18.4 is critical in medical billing, particularly in hospital, ER, or infectious disease care settings.

Billing Notes:

• Ensure accurate documentation of the diagnosis and treatment in the patient's chart.
• Use A18.4 in conjunction with other relevant codes to capture the full clinical picture.
• Document all relevant symptoms and treatment plans to support claims.
• Review payer-specific guidelines for coding and billing requirements.

Common CPT Pairings: