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ICD-10 Coding for Gastric Outlet Obstruction(K31.1, C25.0)

Complete ICD-10-CM coding and documentation guide for Gastric Outlet Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

GOOPyloric ObstructionDuodenal Obstructionstomach obstruction

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Related ICD-10 Code Ranges

Complete code families applicable to Gastric Outlet Obstruction

K31.1-K31.89Primary Range

Diseases of stomach and duodenum

This range includes codes for gastric outlet obstruction and related conditions.

C16-C25

Malignant neoplasms of digestive organs

Relevant for coding GOO due to malignancy.

K91.3-K91.89

Postprocedural disorders of digestive system

Used for postoperative gastric outlet obstruction.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
K31.1Adult pyloric stenosisUse when GOO is due to benign causes like peptic ulcers.
  • Endoscopy confirming pyloric stenosis
  • CT showing gastric distension
C25.0Malignant neoplasm of pancreasUse when GOO is secondary to pancreatic cancer.
  • Pathology report confirming pancreatic adenocarcinoma
  • CT showing tumor invasion into duodenum

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 gastric outlet obstruction

Essential facts and insights about Gastric Outlet Obstruction

The ICD-10 code for gastric outlet obstruction due to benign causes is K31.1. For malignancy-related GOO, use C25.0 with K31.1.

Primary ICD-10-CM Codes for gastric outlet obstruction

K31.1
Adult pyloric stenosis
Billable Code

Decision Criteria

clinical Criteria

  • Endoscopic evidence of benign pyloric stenosis

Applicable To

  • Benign pyloric obstruction

Excludes

  • Malignant gastric outlet obstruction

Clinical Validation Requirements

  • Endoscopy confirming pyloric stenosis
  • CT showing gastric distension

Code-Specific Risks

  • Misclassification if malignancy is present

Coding Notes

  • Ensure documentation specifies benign nature of obstruction.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Other specified diseases of stomach and duodenum

K31.89
Use for unspecified or other specified gastric conditions.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Gastroparesis

K31.84
Gastroparesis is confirmed by normal endoscopy and delayed gastric emptying study.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Gastric Outlet Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K31.1.

Impact

Clinical: Inadequate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential revenue loss

Mitigation Strategy

Ensure thorough documentation of diagnostic findings, Link symptoms to specific diagnoses

Impact

Reimbursement: Incorrect DRG assignment leading to revenue loss., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Ensure documentation specifies if GOO is due to a malignant process.

Impact

Failure to sequence malignancy before obstruction.

Mitigation Strategy

Educate coders on proper sequencing rules.

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 Gastric Outlet Obstruction, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Gastric Outlet Obstruction

Use these documentation templates to ensure complete and accurate documentation for Gastric Outlet Obstruction. These templates include all required elements for proper coding and billing.

Gastroenterology evaluation for GOO

Specialty: Gastroenterology

Required Elements

  • Patient history
  • Imaging results
  • Endoscopy findings

Example Documentation

Patient presents with vomiting and early satiety. CT shows gastric distension. Endoscopy confirms pyloric stenosis.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient with vomiting, suspect obstruction.
Good Documentation Example
CT reveals 4cm pancreatic head mass compressing duodenum with retained gastric contents. Endoscopy confirms complete obstruction at pylorus.
Explanation
The good example provides specific imaging and endoscopic findings, linking the obstruction to a pancreatic mass.

Need help with ICD-10 coding for Gastric Outlet Obstruction? Ask your questions below.

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