ICD-10 Coding for Colic(R10.83, K80.51)
Complete ICD-10-CM coding and documentation guide for Colic. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colic
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R10.83 | Colic | Use for infants meeting the 'rule of three' criteria without other underlying conditions. |
|
| K80.51 | Calculus of bile duct with acute cholecystitis with obstruction | Use when gallstones are confirmed as the cause of colic symptoms. |
|
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 infantile colic
Essential facts and insights about Colic
Primary ICD-10-CM Codes for colic
Decision Criteria
clinical Criteria
- Infant age and symptom duration
coding Criteria
- Exclusion of other diagnoses
Applicable To
- Infantile colic
Excludes
- Biliary colic (K80.51)
Clinical Validation Requirements
- Age ≤12 months
- Crying >3 hours/day, >3 days/week, >3 weeks
- No evidence of organic pathology
Code-Specific Risks
- Incorrect use for patients older than 12 months
- Failure to document the 'rule of three'
Coding Notes
- Ensure age and symptom criteria are met before coding.
K80.51 - Calculus of bile duct with acute cholecystitis with obstruction
Use when gallstones are confirmed as the cause of colic symptoms.
Applicable To
- Biliary colic
Excludes
- Infantile colic (R10.83)
Clinical Validation Requirements
- Right upper quadrant pain
- Vomiting
- Ultrasound shows gallstones
Coding Notes
Ensure imaging confirms gallstones before coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Encounter for health supervision of healthy infant
Z76.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Colic to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R10.83.
Impact
Clinical: Inadequate symptom tracking and management., Regulatory: Non-compliance with coding guidelines., Financial: Potential claim denials due to insufficient documentation.
Mitigation Strategy
Use specific criteria for symptom documentation., Ensure exclusion of other conditions is documented.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with age-specific coding guidelines., Data Quality: Inaccurate patient records and statistics.
Mitigation Strategy
Use R10.84 for older patients with unspecified abdominal pain.
Impact
Incorrect use of R10.83 for patients older than 12 months.
Mitigation Strategy
Implement age verification protocols in coding processes.
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 Colic, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colic
Use these documentation templates to ensure complete and accurate documentation for Colic. These templates include all required elements for proper coding and billing.
Infant with colic symptoms
Specialty: PediatricsRequired Elements
- Age and symptom duration
- Physical findings
- Exclusion of other conditions
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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