ICD-10 Coding for Gallstones(K80.10, K80.20)
Complete ICD-10-CM coding and documentation guide for Gallstones. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gallstones
K80.0-K80.9Primary Range
Cholelithiasis and related disorders
This range covers all forms of gallstones, with or without complications such as cholecystitis or obstruction.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K80.10 | Calculus of gallbladder with acute cholecystitis without obstruction | Use when both gallstones and acute cholecystitis are documented without obstruction. |
|
| K80.20 | Calculus of gallbladder without cholecystitis | Use when gallstones are present without any cholecystitis. |
|
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 cholelithiasis
Essential facts and insights about Gallstones
Primary ICD-10-CM Codes for cholelithiasis
Decision Criteria
clinical Criteria
- Presence of gallstones and acute inflammation on imaging
Applicable To
- Acute cholecystitis with gallstones
Clinical Validation Requirements
- Ultrasound showing gallstones and gallbladder wall thickening
- Elevated white blood cell count
Code-Specific Risks
- Risk of under-documenting the presence of obstruction
Coding Notes
- Ensure documentation specifies 'acute' and confirms gallstones via imaging.
K80.20 - Calculus of gallbladder without cholecystitis
Use when gallstones are present without any cholecystitis.
Applicable To
- Asymptomatic gallstones
Excludes
- Cholecystitis (K81.x)
Clinical Validation Requirements
- Imaging confirming gallstones without signs of inflammation
Coding Notes
Ensure no signs of cholecystitis are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Right upper quadrant pain
R10.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Gallstones to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.10.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Could result in coding audits., Financial: Potential loss of reimbursement for complications.
Mitigation Strategy
Review imaging and lab results thoroughly, Query providers for clarification
Impact
Reimbursement: May lead to reduced reimbursement rates., Compliance: Increases risk of audits and non-compliance., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Ensure documentation supports the most specific code available.
Impact
Increases likelihood of audits due to lack of specificity.
Mitigation Strategy
Ensure documentation supports the most specific code.
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 Gallstones, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gallstones
Use these documentation templates to ensure complete and accurate documentation for Gallstones. These templates include all required elements for proper coding and billing.
Acute cholecystitis with gallstones
Specialty: GastroenterologyRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Laboratory results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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