ICD-10 Coding for Anorectal Pain(K62.5, K56.41, K51.219)
Complete ICD-10-CM coding and documentation guide for Anorectal Pain. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Anorectal Pain
K62-K64Primary Range
Diseases of anus and rectum
This range includes conditions directly related to anorectal pain such as hemorrhoids, anal fissures, and other anorectal disorders.
Symptoms and signs involving the digestive system and abdomen
This range includes symptom codes that may accompany anorectal pain, such as abdominal tenderness and rectal bleeding.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K62.5 | Hemorrhage of anus and rectum | Use when active bleeding from the anus or rectum is confirmed by endoscopic examination. |
|
| K56.41 | Fecal impaction | Use when fecal impaction is confirmed by imaging studies such as an abdominal X-ray. |
|
| K51.219 | Ulcerative proctitis without complications | Use when ulcerative proctitis is confirmed by biopsy. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for anorectal pain
Essential facts and insights about Anorectal Pain
Primary ICD-10-CM Codes for anaorectal pain
Decision Criteria
clinical Criteria
- Active bleeding observed during anoscopy
Applicable To
- Active anorectal bleeding
Excludes
- Hemorrhoids with bleeding (K64.-)
Clinical Validation Requirements
- Documentation of active bleeding observed on anoscopy
Code-Specific Risks
- Risk of using this code without endoscopic confirmation of bleeding.
Coding Notes
- Ensure bleeding is confirmed by diagnostic tests before using this code.
K56.41 - Fecal impaction
Use when fecal impaction is confirmed by imaging studies such as an abdominal X-ray.
Applicable To
- Impacted feces
Excludes
- Constipation NOS (K59.00)
Clinical Validation Requirements
- Imaging confirmation of fecal mass
Coding Notes
Ensure imaging studies confirm the presence of fecal impaction.
K51.219 - Ulcerative proctitis without complications
Use when ulcerative proctitis is confirmed by biopsy.
Applicable To
- Chronic ulcerative proctitis
Excludes
- Ulcerative colitis (K51.0-K51.9)
Clinical Validation Requirements
- Biopsy confirmation of ulcerations
Coding Notes
Biopsy results should be documented to confirm diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Anorectal Pain to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K62.5.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Increases risk of audit failures., Financial: Results in denied claims or reduced reimbursement.
Mitigation Strategy
Ensure all symptoms are linked to confirmed diagnoses., Use diagnostic tests to support clinical findings.
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audit and non-compliance., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure detailed documentation to support the use of specific codes.
Impact
High risk of audit when unspecified codes are used without justification.
Mitigation Strategy
Provide detailed documentation and use specific codes whenever possible.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Anorectal Pain, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Anorectal Pain
Use these documentation templates to ensure complete and accurate documentation for Anorectal Pain. These templates include all required elements for proper coding and billing.
Patient with hemorrhoidal pain
Specialty: GastroenterologyRequired Elements
- History of present illness
- Physical examination findings
- Diagnostic test results
- Treatment plan
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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