ICD-10 Coding for Biliary Stenosis(K83.1, T85.72)
Complete ICD-10-CM coding and documentation guide for Biliary Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Biliary Stenosis
K80-K87Primary Range
Diseases of the gallbladder, biliary tract, and pancreas
This range includes codes for conditions affecting the biliary tract, including biliary stenosis.
Complications of surgical and medical care, not elsewhere classified
This range includes codes for post-procedural complications such as biliary strictures following surgery.
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 documented obstruction or narrowing of the bile duct. |
|
| T85.72 | Stricture of bile duct, postprocedural | Use for strictures occurring after a surgical procedure. |
|
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 stenosis
Essential facts and insights about Biliary Stenosis
Primary ICD-10-CM Codes for biliary stenosis
Decision Criteria
clinical Criteria
- Documented imaging showing obstruction
documentation Criteria
- Detailed description of the stricture's location and severity
Applicable To
- Biliary stenosis
- Bile duct stricture
Clinical Validation Requirements
- MRCP showing >75% narrowing
- Elevated ALP and bilirubin levels
Code-Specific Risks
- Ensure imaging supports the diagnosis
- Avoid unspecified codes when specific ones are available
Coding Notes
- Ensure that the documentation specifies the location and severity of the stenosis.
T85.72 - Stricture of bile duct, postprocedural
Use for strictures occurring after a surgical procedure.
Applicable To
- Post-surgical bile duct stricture
Excludes
- Bile duct obstruction due to stones (K80.3-)
Clinical Validation Requirements
- History of recent biliary surgery
- Imaging confirming stricture
Coding Notes
Link this code with the procedure that led to the stricture.
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 Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K83.1.
Impact
Clinical: May lead to inappropriate treatment, Regulatory: Non-compliance with documentation standards, Financial: Potential for denied claims
Mitigation Strategy
Always document the underlying cause, Link the stricture to any recent procedures
Impact
Reimbursement: May lead to reduced reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Decreases accuracy of clinical data
Mitigation Strategy
Use specific codes like K83.1 when documentation supports it
Impact
Failure to provide detailed imaging reports may lead to audit issues.
Mitigation Strategy
Ensure all imaging findings are thoroughly documented.
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 Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Biliary Stenosis
Use these documentation templates to ensure complete and accurate documentation for Biliary Stenosis. These templates include all required elements for proper coding and billing.
Post-transplant biliary stricture
Specialty: GastroenterologyRequired Elements
- Imaging findings
- Laboratory results
- Surgical history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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