ICD-10 Coding for Biliary Colic(K80.20, K80.50)
Complete ICD-10-CM coding and documentation guide for Biliary Colic. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Biliary Colic
K80-K87Primary Range
Diseases of gallbladder, biliary tract, and pancreas
This range includes codes for gallstones and related biliary conditions, which are essential for coding biliary colic.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K80.20 | Calculus of gallbladder without cholecystitis | Use when gallstones are confirmed by imaging and there is no evidence of cholecystitis. |
|
| K80.50 | Calculus of bile duct without cholangitis or cholecystitis | Use when imaging confirms bile duct stones without inflammation. |
|
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 biliary colic
Essential facts and insights about Biliary Colic
Primary ICD-10-CM Codes for biliary colic
Decision Criteria
clinical Criteria
- Ultrasound shows gallstones without wall thickening
documentation Criteria
- Document postprandial pain and imaging findings
Applicable To
- Gallstones without inflammation
Excludes
- Cholecystitis (K81.-)
Clinical Validation Requirements
- Ultrasound confirmation of gallstones
- Absence of gallbladder wall thickening
- Postprandial right upper quadrant pain
Code-Specific Risks
- Misclassification if imaging does not confirm gallstones
Coding Notes
- Ensure imaging confirms gallstones and absence of cholecystitis.
K80.50 - Calculus of bile duct without cholangitis or cholecystitis
Use when imaging confirms bile duct stones without inflammation.
Applicable To
- Bile duct stones without inflammation
Excludes
- Cholangitis (K83.0)
Clinical Validation Requirements
- MRCP or ERCP showing bile duct stones
- Elevated liver enzymes (ALKP, GGT)
Coding Notes
Ensure bile duct stones are confirmed by imaging.
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 Biliary Colic to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.20.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Specify pain location and characteristics., Include imaging findings in documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify stone location with imaging before coding.
Impact
High misclassification rate due to lack of imaging confirmation.
Mitigation Strategy
Ensure all codes are supported by imaging and clinical documentation.
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 Biliary Colic, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Biliary Colic
Use these documentation templates to ensure complete and accurate documentation for Biliary Colic. These templates include all required elements for proper coding and billing.
Emergency Department Visit for Biliary Colic
Specialty: Emergency MedicineRequired Elements
- Onset and duration of pain
- Location and radiation of pain
- Imaging findings
- Laboratory results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Biliary Colic? Ask your questions below.