ICD-10 Coding for Lower Gastrointestinal Bleed(K57.31, K55.21, K92.2)
Complete ICD-10-CM coding and documentation guide for Lower Gastrointestinal Bleed. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lower Gastrointestinal Bleed
K55-K64Primary Range
Diseases of the intestines
This range includes conditions that are common causes of lower gastrointestinal bleeding, such as diverticulosis and angiodysplasia.
Other diseases of the digestive system
This range includes unspecified gastrointestinal hemorrhage codes used when the source of bleeding is not identified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K57.31 | Diverticulosis of large intestine with hemorrhage | Use when diverticulosis is documented as the source of bleeding. |
|
| K55.21 | Angiodysplasia of colon with hemorrhage | Use when angiodysplasia is documented as the source of bleeding. |
|
| K92.2 | Unspecified gastrointestinal hemorrhage | Use when the source of bleeding is not identified after thorough investigation. |
|
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 lower gastrointestinal bleed
Essential facts and insights about Lower Gastrointestinal Bleed
Primary ICD-10-CM Codes for lower gastrointestinal bleed
Decision Criteria
clinical Criteria
- Documented diverticulosis with active bleeding
Applicable To
- Diverticular disease of large intestine with bleeding
Excludes
- Diverticulitis of large intestine with perforation and abscess (K57.20)
Clinical Validation Requirements
- Endoscopy report showing blood clot adherent to diverticulum
- Colonoscopy confirming active diverticular bleeding
Code-Specific Risks
- Incorrect use when bleeding source is not confirmed as diverticulosis.
Coding Notes
- Ensure documentation specifies diverticulosis as the bleeding source.
K55.21 - Angiodysplasia of colon with hemorrhage
Use when angiodysplasia is documented as the source of bleeding.
Applicable To
- Angiodysplasia of colon with bleeding
Excludes
- Angiodysplasia of stomach and duodenum with hemorrhage (K31.811)
Clinical Validation Requirements
- CTA findings showing early filling vein with vascular tuft
- Colonoscopy visualization of angiodysplasia with active bleeding
Coding Notes
Ensure documentation specifies angiodysplasia as the bleeding source.
K92.2 - Unspecified gastrointestinal hemorrhage
Use when the source of bleeding is not identified after thorough investigation.
Applicable To
- Gastrointestinal bleeding NOS
Excludes
- Hemorrhage of anus and rectum (K62.5)
Clinical Validation Requirements
- Negative imaging/endoscopy with persistent bleeding symptoms
- Orthostatic BP changes, Hb <10 g/dL, BUN/Cr ratio >30
Coding Notes
Use only when no specific source of bleeding is identified.
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 Lower Gastrointestinal Bleed to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.31.
Impact
Clinical: Leads to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure detailed documentation of symptoms and findings, Use specific medical terminology
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: May result in non-compliance with coding guidelines., Data Quality: Affects the accuracy of clinical data and statistics.
Mitigation Strategy
Use specific combination codes like K57.31 or K55.21 when the source is documented.
Impact
High audit risk for using unspecified codes when specific sources are documented.
Mitigation Strategy
Ensure thorough documentation and use of specific codes when 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 Lower Gastrointestinal Bleed, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lower Gastrointestinal Bleed
Use these documentation templates to ensure complete and accurate documentation for Lower Gastrointestinal Bleed. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: Emergency MedicineRequired Elements
- Presenting symptoms
- Vital signs
- Imaging results
- Colonoscopy findings
- Treatment response
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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