ICD-10 Coding for Appendicolith(K38.1, K35.211)
Complete ICD-10-CM coding and documentation guide for Appendicolith. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Appendicolith
K35-K38Primary Range
Diseases of appendix
This range includes codes for appendicitis and related conditions, including appendicolith.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K38.1 | Appendicular concretions | Use when appendicolith is present without acute appendicitis. |
|
| K35.211 | Acute appendicitis with perforation and appendicolith | Use when appendicolith is causing perforation. |
|
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 appendicolith
Essential facts and insights about Appendicolith
Primary ICD-10-CM Codes for appendicolith
Decision Criteria
clinical Criteria
- Imaging shows appendicolith without signs of appendicitis.
Applicable To
- Fecalith
- Stercolith
Excludes
- Acute appendicitis with appendicolith (K35.-)
Clinical Validation Requirements
- Imaging confirmation of appendicolith
- CT density measurement (Hounsfield units)
Code-Specific Risks
- Incorrectly using as primary code when appendicitis is present
Coding Notes
- Ensure imaging confirms appendicolith presence.
K35.211 - Acute appendicitis with perforation and appendicolith
Use when appendicolith is causing perforation.
Excludes
- Appendicular concretions without appendicitis (K38.1)
Clinical Validation Requirements
- Imaging confirmation of appendicolith with signs of perforation
- Elevated WBC count
Coding Notes
Ensure documentation includes perforation details.
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 Appendicolith to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K38.1.
Impact
Clinical: Potential misdiagnosis of appendicitis., Regulatory: Non-compliance with coding standards., Financial: Denied claims due to insufficient documentation.
Mitigation Strategy
Require radiologist report for confirmation.
Impact
Reimbursement: Incorrect reimbursement due to wrong DRG assignment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use K35 series codes as primary when appendicitis is present.
Impact
Using K38.1 as primary when appendicitis is present.
Mitigation Strategy
Educate coders on proper code sequencing.
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 Appendicolith, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Appendicolith
Use these documentation templates to ensure complete and accurate documentation for Appendicolith. These templates include all required elements for proper coding and billing.
Acute appendicitis with appendicolith
Specialty: General SurgeryRequired Elements
- Imaging findings
- Surgical notes
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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