ICD-10 Coding for Celiac Sprue(K90.0)
Complete ICD-10-CM coding and documentation guide for Celiac Sprue. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Celiac Sprue
K90-K93Primary Range
Other diseases of intestines
This range includes celiac disease and related intestinal disorders.
Key Information: ICD-10 code for celiac sprue
Essential facts and insights about Celiac Sprue
Primary ICD-10-CM Code for celiac sprue
Decision Criteria
clinical Criteria
- Biopsy showing Marsh 3c changes
documentation Criteria
- Positive tTG IgA serology
Applicable To
- Celiac sprue
- Nontropical sprue
Excludes
- Non-celiac gluten sensitivity (K90.41)
Clinical Validation Requirements
- Biopsy-proven villous atrophy
- Positive serology (tTG IgA/EMA)
Code-Specific Risks
- Incorrectly coding for gluten sensitivity without biopsy confirmation.
Coding Notes
- Ensure biopsy and serology results are documented to support the use of K90.0.
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.
Non-celiac gluten sensitivity
K90.41Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Celiac Sprue to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K90.0.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential denial of claims.
Mitigation Strategy
Verify biopsy results before coding.
Impact
Reimbursement: May result in lower reimbursement if associated conditions are not coded., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Add L13.0 when dermatitis herpetiformis is confirmed.
Impact
Audits may check for biopsy documentation when coding K90.0.
Mitigation Strategy
Ensure all biopsy results are included in patient records.
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 Celiac Sprue, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Celiac Sprue
Use these documentation templates to ensure complete and accurate documentation for Celiac Sprue. These templates include all required elements for proper coding and billing.
Celiac disease diagnosis
Specialty: GastroenterologyRequired Elements
- Symptoms
- Family history
- Lab results
- Biopsy findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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