ICD-10 Coding for Portal Hypertensive Gastropathy(K31.88, K76.6)
Complete ICD-10-CM coding and documentation guide for Portal Hypertensive Gastropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Portal Hypertensive Gastropathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K31.88 | Other specified diseases of stomach and duodenum | Use when endoscopic findings confirm PHG linked to portal hypertension. |
|
| K76.6 | Portal hypertension | Use when portal hypertension is confirmed as underlying cause. |
|
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 portal hypertensive gastropathy
Essential facts and insights about Portal Hypertensive Gastropathy
Primary ICD-10-CM Codes for portal hypertensive gastropathy
Decision Criteria
clinical Criteria
- Endoscopic confirmation of PHG
documentation Criteria
- Explicit mention of portal hypertension as cause
Applicable To
- Portal hypertensive gastropathy
Excludes
- Peptic ulcer disease
- Gastric antral vascular ectasia
Clinical Validation Requirements
- Endoscopic findings of mosaic pattern or snake-skin mucosa
- Histopathology showing dilated capillaries without inflammation
Code-Specific Risks
- Incorrectly coding without linking to portal hypertension
Coding Notes
- Ensure documentation explicitly links PHG to portal hypertension.
K76.6 - Portal hypertension
Use when portal hypertension is confirmed as underlying cause.
Applicable To
- Portal hypertension due to cirrhosis
Excludes
- Primary biliary cholangitis
Clinical Validation Requirements
- Imaging showing portal vein diameter >13mm
- Clinical signs of portal hypertension
Coding Notes
Must be sequenced before K31.88 when coding PHG.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Portal hypertension
K76.6Differential 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 Portal Hypertensive Gastropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K31.88.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Use specific terms like 'portal hypertensive gastropathy'., Ensure endoscopic findings are documented.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always include K76.6 to indicate portal hypertension.
Impact
Failure to document the link between PHG and portal hypertension.
Mitigation Strategy
Educate providers on documentation requirements.
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 Portal Hypertensive Gastropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Portal Hypertensive Gastropathy
Use these documentation templates to ensure complete and accurate documentation for Portal Hypertensive Gastropathy. These templates include all required elements for proper coding and billing.
Patient with cirrhosis and PHG
Specialty: GastroenterologyRequired Elements
- History of liver disease
- Endoscopic findings
- Linkage to portal hypertension
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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