ICD-10 Coding for History of Gastric Ulcer(Z87.11)
Complete ICD-10-CM coding and documentation guide for History of Gastric Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to History of Gastric Ulcer
Key Information: ICD-10 code for history of gastric ulcer
Essential facts and insights about History of Gastric Ulcer
Primary ICD-10-CM Code for history of gastric ulcer
Decision Criteria
clinical Criteria
- Patient has a documented history of a gastric ulcer that is no longer active.
coding Criteria
- Do not use for active ulcers; use K25-K28 codes instead.
Applicable To
- History of gastric ulcer
- History of duodenal ulcer
Excludes
- Current peptic ulcer disease (K25-K28)
Clinical Validation Requirements
- Documentation of healed gastric ulcer
- Endoscopy reports confirming no active disease
Code-Specific Risks
- Ensure the ulcer is not currently active to avoid incorrect coding.
Coding Notes
- Ensure documentation specifies 'history of gastric ulcer' to avoid confusion with active conditions.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting History of Gastric Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z87.11.
Impact
Clinical: Potential misinterpretation of patient history., Regulatory: Non-compliance with documentation standards., Financial: Possible claim denials or audits.
Mitigation Strategy
Use specific language in documentation., Verify historical details with patient records.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Use Z87.11 for historical documentation of gastric ulcers.
Impact
Audits may focus on the specificity of historical documentation for gastric ulcers.
Mitigation Strategy
Ensure all documentation clearly specifies the ulcer type and healing status.
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 History of Gastric Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for History of Gastric Ulcer
Use these documentation templates to ensure complete and accurate documentation for History of Gastric Ulcer. These templates include all required elements for proper coding and billing.
Gastroenterology Follow-up
Specialty: GastroenterologyRequired Elements
- Healed status of gastric ulcer
- Date of last endoscopy
- Current medications
- Risk factors addressed
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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