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New subchapters get specific for diseases of the digestive system

By Judy Monestime  bio

ICD-10-CM Chapter 11, “Diseases of the Digestive System (K00–K95),” contains common conditions that patients experience in their gastrointestinal tract. This section contains gastrointestinal (GI) conditions that occur in many patients from infections in the mouth and organs in the upper GI tract as well as in the appendix, small bowel, colon, gallbladder, and liver.

A number of new subchapters have been added to the chapter on diseases of the digestive system. For instance, in ICD-10-CM diseases of the liver have their subchapter or block while these conditions were grouped with other diseases of the digestive system in ICD-9-CM.

Some terminology changes, and revisions to the classification of specific digestive conditions have occurred in ICD-10-CM as well.

The chapter includes the following sections:

  • K00-K14, Diseases of oral cavity and salivary glands
  • K20-K31, Diseases of esophagus, stomach and duodenum
  • K35-K38, Diseases of appendix
  • K40-K46, Hernia
  • K50-K52, Non-infective enteritis and colitis
  • K55-K64, Other diseases of intestines
  • K65-K68, Diseases of peritoneum and retroperitoneum
  • K70-K77, Diseases of liver
  • K80-K87, Disorders of gallbladder, biliary tract, and pancreas
  • K90-K95, Other diseases of the digestive system

Some of the disease categories in Chapter 11 have been restructured to bring together those groups that are in some way related. For example, Chapter 11 contains two new sections: Diseases of liver (K70-K77) and Disorders of gallbladder, biliary tract, and pancreas (K80-K87). In some cases, headings of subcategories have been changed; for example, angiodysplasia of intestine is in a subcategory for “other specified disorders of intestine” in ICD-9-CM, whereas it is in a subcategory for “vascular disorders of intestine” in ICD-10-CM.

Crohn’s Disease (Regional Enteriris) (K50)

ICD-10-CM category K50, Crohn’s disease, has been expanded to the fourth, fifth, and sixth character in contrast to ICD-9-CM category 555, Regional enteritis. The expansion at the fourth character level specifies the site of the Crohn’s disease, the fifth character indicates whether a complication was present, and the sixth character further classifies the particular difficulty.

For example, the associated clinical manifestation of rectal bleeding, intestinal obstruction, fistula or abscess as well as other complications are identified with the sixth character under each site. Without further specification as to site and complication, assign code K50.90 for Crohn’s disease.

A note appears under the category to Use additional code to identify manifestations, such as: pyoderma gangrenosum (L88).

K50.01 Crohn’s disease of small intestine with complications

K50.011 Crohn’s disease of small intestine with rectal bleeding

K50.012 Crohn’s disease of small intestine with intestinal obstruction

K50.013 Crohn’s disease of small intestine with fistula

K50.014 Crohn’s disease of small intestine with abscess

K50.018 Crohn’s disease of small intestine with other complication

K50.019 Crohn’s disease of small intestine with unspecified complications

Let’s practice! How do you code the following encounter?

This 43-year-old man has been treated for Crohn’s disease of the small intestine since he was 22 years old. He has had several exacerbations of the disease in the past years. At this time, small bowel X-ray shows a small bowel obstruction. The obstruction was found to be a result of an exacerbation of his Crohn’s disease. What is the correct diagnosis code(s)?

K50.012 Crohn’s disease of small intestine with intestinal obstruction

Rationale: An additional code for the small bowel obstruction is not required, as the combination code in ICD-10-CM identifies both the Crohn’s disease and the small bowel obstruction. Exacerbation is not a qualifier for Crohn’s disease.

Judy Monestime, MBA, CDIP, CPC, is an AHIMA-approved ICD-10-CM/PCS trainer.









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