ICD-10 Coding for Cholestasis(O26.64-, K71.0, K83.1, Q44.2)
Complete ICD-10-CM coding and documentation guide for Cholestasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cholestasis
O26.64-Primary Range
Intrahepatic cholestasis of pregnancy
Primary range for pregnancy-related cholestasis, requiring additional Z3A.- code for gestation.
Toxic liver disease with cholestasis
Used for cholestasis due to toxic agents, including drug-induced cases.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| O26.64- | Intrahepatic cholestasis of pregnancy | Use for pregnant patients with documented intrahepatic cholestasis. |
|
| K71.0 | Toxic liver disease with cholestasis | Use for cholestasis due to known toxic agents. |
|
| K83.1 | Obstructive cholestasis | Use for cases with confirmed physical obstruction of bile flow. |
|
| Q44.2 | Congenital biliary atresia | Use for congenital absence or closure of bile ducts. |
|
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 intrahepatic cholestasis of pregnancy
Essential facts and insights about Cholestasis
Primary ICD-10-CM Codes for cholestasis
Decision Criteria
clinical Criteria
- Presence of pruritus and elevated bile acids in pregnancy.
Applicable To
- Pregnancy-related cholestasis
Excludes
- Obstructive cholestasis
Clinical Validation Requirements
- Bile acids >10 μmol/L
- Normal biliary tree on ultrasound
Code-Specific Risks
- Incorrectly coding as obstructive cholestasis
Coding Notes
- Ensure documentation specifies intrahepatic cholestasis and gestational age.
K71.0 - Toxic liver disease with cholestasis
Use for cholestasis due to known toxic agents.
Applicable To
- Drug-induced cholestasis
Excludes
- Obstructive cholestasis
Clinical Validation Requirements
- R value (ALT/ALP) <2
- Negative viral hepatitis panel
Coding Notes
Document the specific toxic agent causing cholestasis.
K83.1 - Obstructive cholestasis
Use for cases with confirmed physical obstruction of bile flow.
Applicable To
- Cholestasis due to bile duct obstruction
Excludes
- Intrahepatic cholestasis of pregnancy
Clinical Validation Requirements
- Imaging confirming bile duct obstruction
Coding Notes
Ensure imaging supports the diagnosis of obstruction.
Q44.2 - Congenital biliary atresia
Use for congenital absence or closure of bile ducts.
Applicable To
- Congenital absence of bile ducts
Excludes
- Acquired biliary atresia
Clinical Validation Requirements
- HIDA scan showing no biliary excretion
Coding Notes
Requires confirmation through imaging or surgical findings.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Cholestasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code O26.64-.
Impact
Clinical: Inaccurate clinical picture of pregnancy status., Regulatory: Non-compliance with coding guidelines., Financial: Potential reimbursement issues due to incomplete coding.
Mitigation Strategy
Always include gestational age in documentation., Use templates that prompt for gestational details.
Impact
Clinical: Misguided treatment plans., Regulatory: Incorrect coding leading to compliance issues., Financial: Incorrect DRG assignment affecting reimbursement.
Mitigation Strategy
Ensure thorough clinical evaluation and documentation., Use decision support tools for accurate coding.
Impact
Reimbursement: Incorrect DRG assignment affecting reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Use O26.64- for pregnancy-related cases.
Impact
Reimbursement: Potential denial due to unspecified coding., Compliance: Non-compliance with coding specificity requirements., Data Quality: Loss of specific clinical information.
Mitigation Strategy
Clarify with the provider for specific type of cholestasis.
Impact
Failure to document gestational age with ICP codes.
Mitigation Strategy
Implement mandatory fields in EHR for gestational age when coding ICP.
Impact
Lack of documentation for the causative toxic agent in cholestasis cases.
Mitigation Strategy
Require documentation of drug/toxin exposure in all relevant cases.
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 Cholestasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cholestasis
Use these documentation templates to ensure complete and accurate documentation for Cholestasis. These templates include all required elements for proper coding and billing.
Intrahepatic Cholestasis of Pregnancy
Specialty: ObstetricsRequired Elements
- Chief complaint
- Laboratory results
- Imaging findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Toxic Cholestasis
Specialty: HepatologyRequired Elements
- History of present illness
- Laboratory findings
- Imaging results
- Diagnosis and treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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