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ICD-10 Coding for Choledocholithiasis(K80.50, K80.51)

Complete ICD-10-CM coding and documentation guide for Choledocholithiasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Bile duct stonesCommon bile duct stones

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Related ICD-10 Code Ranges

Complete code families applicable to Choledocholithiasis

K80-K83Primary Range

Diseases of gallbladder, biliary tract, and pancreas

This range includes codes for choledocholithiasis and related biliary conditions.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
K80.50Calculus of bile duct without cholangitis or cholecystitis, without obstructionUse when CBD stones are present without evidence of obstruction or inflammation.
  • Imaging-confirmed CBD stones without obstruction
  • Normal liver function tests
K80.51Calculus of bile duct without cholangitis or cholecystitis, with obstructionUse when imaging and lab results confirm obstruction due to CBD stones.
  • CBD stone ≥ 5mm
  • Dilated CBD > 8mm on imaging
  • Elevated bilirubin > 2mg/dL

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 choledocholithiasis with obstruction

Essential facts and insights about Choledocholithiasis

The ICD-10 code for choledocholithiasis with obstruction is K80.51, used when obstruction is confirmed by imaging and lab results.

Primary ICD-10-CM Codes for choledocholithiasis

K80.50
Calculus of bile duct without cholangitis or cholecystitis, without obstruction
Billable Code

Decision Criteria

clinical Criteria

  • CBD stones confirmed without obstruction

Applicable To

  • Bile duct stones without obstruction

Excludes

  • Cholangitis (K83.0)
  • Cholecystitis (K81.-)

Clinical Validation Requirements

  • Imaging-confirmed CBD stones without obstruction
  • Normal liver function tests

Code-Specific Risks

  • Misclassification if obstruction is not documented

Coding Notes

  • Ensure documentation specifies absence of obstruction for accurate coding.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Right upper quadrant abdominal pain

R10.11
Use if pain is documented and not inherent to the obstruction.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Calculus of bile duct without cholangitis or cholecystitis, with obstruction

K80.51
Presence of obstruction indicated by elevated bilirubin and dilated CBD on imaging.

Calculus of bile duct without cholangitis or cholecystitis, without obstruction

K80.50
Absence of obstruction indicators such as normal bilirubin levels and CBD size.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Choledocholithiasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.50.

Impact

Clinical: May lead to inappropriate treatment decisions., Regulatory: Could result in audit discrepancies., Financial: Potential loss of reimbursement due to incorrect DRG assignment.

Mitigation Strategy

Ensure thorough review of imaging and lab results., Use standardized templates for documentation.

Impact

Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: May result in compliance issues during audits., Data Quality: Affects the accuracy of clinical data records.

Mitigation Strategy

Ensure documentation clearly states whether obstruction is present.

Impact

Failure to document obstruction can lead to audit findings.

Mitigation Strategy

Implement mandatory documentation checks for obstruction indicators.

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 Choledocholithiasis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Choledocholithiasis

Use these documentation templates to ensure complete and accurate documentation for Choledocholithiasis. These templates include all required elements for proper coding and billing.

Emergency Department Presentation

Specialty: Emergency Medicine

Required Elements

  • RUQ pain onset and characteristics
  • Jaundice presence
  • LFT results
  • Imaging findings
  • ERCP findings

Example Documentation

[ ] RUQ pain onset [X] hours ago, radiating to back [ ] Jaundice present: Yes/No [ ] LFTs: Total bili ____, Direct bili ____, ALT ____, AST ____, ALP ____ [ ] Imaging: CBD diameter ____ mm, stone size ____ mm (modality: US/CT/MRCP) [ ] ERCP findings: Stone extraction [ ] successful [ ] unsuccessful

Examples: Poor vs. Good Documentation

Poor Documentation Example
Gallstones present
Good Documentation Example
8mm obstructing stone in distal CBD confirmed by ERCP, CBD dilated to 10mm, total bilirubin 3.2 mg/dL
Explanation
The good example provides specific measurements and confirms obstruction, supporting accurate coding.

Need help with ICD-10 coding for Choledocholithiasis? Ask your questions below.

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