ICD-10 Coding for Cholelithiasis(K80.00, K80.20)
Complete ICD-10-CM coding and documentation guide for Cholelithiasis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cholelithiasis
K80-K80.9Primary Range
Cholelithiasis
This range includes all codes related to 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 |
|---|---|---|---|
| K80.00 | Acute cholecystitis with cholelithiasis without obstruction | Use when acute cholecystitis is confirmed with gallstones but no obstruction is present. |
|
| K80.20 | Cholelithiasis without cholecystitis | Use for incidental findings of gallstones without symptoms or inflammation. |
|
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 colelitiasis
Essential facts and insights about Cholelithiasis
Primary ICD-10-CM Codes for colelitiasis
Decision Criteria
clinical Criteria
- Presence of acute inflammation without duct obstruction
Applicable To
- Acute cholecystitis with gallstones
Excludes
- Chronic cholecystitis with cholelithiasis (K80.10)
Clinical Validation Requirements
- Imaging showing gallstones and gallbladder wall thickening
- Clinical signs of acute cholecystitis
Code-Specific Risks
- Misclassification if obstruction is present but not documented
Coding Notes
- Ensure documentation specifies absence of obstruction.
K80.20 - Cholelithiasis without cholecystitis
Use for incidental findings of gallstones without symptoms or inflammation.
Applicable To
- Asymptomatic gallstones
Excludes
- Cholelithiasis with cholecystitis (K80.00-K80.01)
Clinical Validation Requirements
- Imaging confirming gallstones without inflammation
Coding Notes
Document absence of symptoms or inflammation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Right upper quadrant pain
R10.11Differential 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 Cholelithiasis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.00.
Impact
Clinical: Leads to incorrect diagnosis and treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials.
Mitigation Strategy
Ensure imaging reports are included in patient records., Train staff on documentation standards.
Impact
Reimbursement: May lead to denied claims or reduced reimbursement., Compliance: Increases risk of audits., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Ensure imaging and clinical findings are documented to support specific codes.
Impact
High audit risk when using unspecified codes without supporting documentation.
Mitigation Strategy
Ensure all documentation supports the specificity of the code used.
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 Cholelithiasis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cholelithiasis
Use these documentation templates to ensure complete and accurate documentation for Cholelithiasis. These templates include all required elements for proper coding and billing.
Laparoscopic cholecystectomy
Specialty: General SurgeryRequired Elements
- Operative findings
- Pathology results
- Imaging reports
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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