ICD-10 Coding for Biliary Obstruction(K83.1, K80.51)
Complete ICD-10-CM coding and documentation guide for Biliary Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Biliary Obstruction
K80-K83Primary Range
Diseases of gallbladder, biliary tract, and pancreas
This range includes codes for conditions affecting the biliary tract, including obstructions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K83.1 | Obstruction of bile duct | Use when there is a mechanical obstruction of the bile duct without a more specific etiology. |
|
| K80.51 | Calculus of bile duct without cholangitis or cholecystitis with obstruction | Use when the obstruction is specifically due to gallstones. |
|
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 obstruction
Essential facts and insights about Biliary Obstruction
Primary ICD-10-CM Codes for biliary obstruction
Decision Criteria
clinical Criteria
- Presence of mechanical blockage confirmed by imaging
Applicable To
- Mechanical blockage of bile duct
Clinical Validation Requirements
- Elevated bilirubin levels
- Imaging evidence of obstruction
Code-Specific Risks
- Misuse when a more specific code is applicable
Coding Notes
- Ensure documentation specifies the cause of obstruction if known.
K80.51 - Calculus of bile duct without cholangitis or cholecystitis with obstruction
Use when the obstruction is specifically due to gallstones.
Applicable To
- Gallstone obstruction
Excludes
- Cholangitis (K83.0)
Clinical Validation Requirements
- Imaging showing gallstones causing obstruction
Coding Notes
Document the presence of gallstones clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified jaundice
R17Differential 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 Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K83.1.
Impact
Clinical: Inadequate information for treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always include imaging results in the patient record.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use K80.51 when gallstones are the cause of obstruction.
Impact
Using K83.1 when gallstones are present.
Mitigation Strategy
Educate coders on differentiation between K83.1 and K80.51.
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 Obstruction, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Biliary Obstruction
Use these documentation templates to ensure complete and accurate documentation for Biliary Obstruction. These templates include all required elements for proper coding and billing.
Acute Biliary Obstruction
Specialty: GastroenterologyRequired Elements
- History of present illness
- Imaging findings
- Laboratory results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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