ICD-10 Code A21.3 | Gastrointestinal tularemia Symptoms, Diagnosis, Billing

Gastrointestinal tularemia is an infectious disease caused by the bacterium Francisella tularensis, primarily transmitted through ingestion of contaminated food or water. This condition is clinically significant due to its potential for severe gastrointestinal symptoms and systemic complications. Accurate coding with ICD-10 Code A21.3 is essential for proper diagnosis, documentation, medical billing, and public health reporting, ensuring appropriate management and resource allocation.

What is ICD-10 Code A21.3 for Gastrointestinal tularemia?

ICD-10 Code A21.3 represents Gastrointestinal tularemia, a form of tularemia characterized by gastrointestinal symptoms such as abdominal pain, diarrhea, and vomiting. This code should be used in clinical documentation and billing when a patient presents with these symptoms, particularly following exposure to potential sources of infection, to ensure accurate diagnosis and treatment.

ICD-10 Code A21.3 – Clinical Definition and Explanation of Gastrointestinal tularemia

Gastrointestinal tularemia is caused by the bacterium Francisella tularensis, which can enter the body through ingestion of contaminated food or water. The condition can progress rapidly, leading to severe gastrointestinal distress and systemic illness, necessitating prompt medical attention.

Key Clinical Features:

• Acute onset of abdominal pain and cramping.
• Nausea and vomiting, often accompanied by diarrhea.
• Fever and chills as systemic symptoms.
• History of exposure to contaminated sources, such as undercooked meat or untreated water.

ICD-10 Code A21.3 for Gastrointestinal tularemia – SOAP Notes & Clinical Use

In SOAP notes, ICD-10 Code A21.3 is utilized to document the patient's symptoms, assessment findings, and treatment plan for gastrointestinal tularemia. This code is relevant in both acute and chronic care settings, facilitating accurate communication among healthcare providers and ensuring appropriate billing.

What Does ICD-10 Code A21.3 for Gastrointestinal tularemia Mean in SOAP Notes?

ICD-10 Code A21.3 connects subjective patient-reported symptoms and objective clinical findings to a formal diagnosis of gastrointestinal tularemia. This code is crucial for ensuring continuity of care, supporting accurate billing, and meeting EHR documentation standards.

Treatment Options for ICD-10 Code A21.3 – Gastrointestinal tularemia

Gastrointestinal tularemia requires prompt medical intervention, often necessitating hospitalization for severe cases. Appropriate antibiotic therapy is critical for effective treatment.

Antibiotic Therapy:

• First-line: Streptomycin (7-14 days) or Gentamicin (7-14 days).
• Alternative: Doxycycline (10-21 days) for patients unable to tolerate aminoglycosides.
• Consideration of Ciprofloxacin (7-14 days) in specific cases.

Supportive Care:

• Hydration and electrolyte management.
• Symptomatic treatment for pain and fever.
• Monitoring for complications such as dehydration or septicemia.

Infection Control:

• Strict adherence to hygiene and sanitation protocols.
• Isolation precautions if necessary during outbreaks.
• Education on food safety and proper cooking methods.

How to Document Symptoms of Gastrointestinal tularemia (ICD-10 A21.3) in SOAP Notes

Subjective:

• Patient reports sudden onset of abdominal pain.
• Complaints of nausea and multiple episodes of vomiting.
• History of consuming undercooked game meat.
• Fever and chills noted by the patient.

Objective:

• Abdominal tenderness on palpation.
• Vital signs: Fever (temperature 101°F), tachycardia.
• Laboratory findings: Elevated white blood cell count.
• Possible signs of dehydration.

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SOAP Note Guidelines for Diagnosing Gastrointestinal tularemia (ICD-10 Code A21.3)

Assessment:

• Diagnosis: Gastrointestinal tularemia, moderate severity.
• ICD-10 Code: A21.3.
• Contributing factors: Recent consumption of potentially contaminated food.
• Consideration of differential diagnoses such as gastroenteritis.

Plan:

• Initiate antibiotic therapy with Streptomycin.
• Provide education on hydration and dietary modifications.
• Monitor vital signs and laboratory parameters closely.
• Schedule follow-up in 1 week to reassess symptoms.

Treatment & Plan Section for ICD-10 Code A21.3 – Gastrointestinal tularemia

• First-line pharmacologic treatment with Streptomycin or Gentamicin.
• Non-pharmacologic strategies include hydration and dietary adjustments.
• Monitoring for symptom resolution and potential complications.
• Follow-up appointments to ensure recovery and prevent recurrence.

Using ICD-10 Code A21.3 for Gastrointestinal tularemia in Billing & SOAP Note Compliance

• Select appropriate ICD-10 code based on clinical presentation 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 for services rendered during the visit.

Related ICD-10 Codes Often Used with Gastrointestinal tularemia

• A21.0 – Tularemia, ulceroglandular
• A21.1 – Tularemia, glandular
• A21.2 – Tularemia, pneumonic
• A21.8 – Other forms of tularemia

ICD-10 Code A21.3 in Medical Billing and Insurance for Gastrointestinal tularemia

ICD-10 Code A21.3 is critical in medical billing, particularly in hospital, emergency room, or infectious disease care settings.

Billing Notes:

• Ensure accurate documentation of symptoms and treatment to support claims.
• Use the code in conjunction with relevant clinical findings for comprehensive billing.
• Document all relevant patient history and exposure risks to justify the diagnosis.
• Include detailed notes on treatment plans and follow-up care.

Common CPT Pairings: