ICD-10 Coding for Biliary Duct Obstruction(K83.1, K80.5)
Complete ICD-10-CM coding and documentation guide for Biliary Duct Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Biliary Duct Obstruction
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K83.1 | Obstruction of bile duct | Use when obstruction is confirmed without the presence of gallstones. |
|
| K80.5 | Obstruction of bile duct with cholelithiasis | Use when gallstones are confirmed as the cause of obstruction. |
|
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 biliary duct obstruction
Essential facts and insights about Biliary Duct Obstruction
Primary ICD-10-CM Codes for biliary duct obstruction
Decision Criteria
clinical Criteria
- Imaging shows stricture without stones
documentation Criteria
- Documentation specifies 'stricture without cholelithiasis'
Applicable To
- Stricture of bile duct without cholelithiasis
Clinical Validation Requirements
- Imaging showing stricture without stones
- ERCP confirming obstruction without calculi
Code-Specific Risks
- Misuse when gallstones are present
Coding Notes
- Ensure documentation specifies absence of gallstones.
K80.5 - Obstruction of bile duct with cholelithiasis
Use when gallstones are confirmed as the cause of obstruction.
Applicable To
- Choledocholithiasis with obstruction
Excludes
- Obstruction without stones (K83.1)
Clinical Validation Requirements
- Imaging or ERCP showing stones causing obstruction
Coding Notes
Ensure gallstones are documented as the cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified jaundice
R17Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Biliary Duct Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K83.1.
Impact
Clinical: Misleading clinical picture, Regulatory: Potential audit flags, Financial: Incorrect billing and reimbursement
Mitigation Strategy
Ensure thorough documentation of diagnostic findings, Use specific terminology in notes
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use K80.5 if stones are confirmed as the cause.
Impact
Using K83.1 when stones are present
Mitigation Strategy
Regular training on code differentiation
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 Biliary Duct Obstruction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Biliary Duct Obstruction
Use these documentation templates to ensure complete and accurate documentation for Biliary Duct Obstruction. These templates include all required elements for proper coding and billing.
Biliary obstruction without stones
Specialty: GastroenterologyRequired Elements
- History of present illness
- Imaging findings
- ERCP results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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