ICD-10 Coding for Endoscopic Retrograde Cholangiopancreatography(K80.20)
Complete ICD-10-CM coding and documentation guide for Endoscopic Retrograde Cholangiopancreatography. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Endoscopic Retrograde Cholangiopancreatography
K80-K87Primary Range
Diseases of the gallbladder, biliary tract, and pancreas
This range includes conditions that are commonly diagnosed and treated using ERCP procedures.
Key Information: ICD-10 code for ERCP with stone removal
Essential facts and insights about Endoscopic Retrograde Cholangiopancreatography
Primary ICD-10-CM Code for ercp
Decision Criteria
clinical Criteria
- Presence of gallstones and acute cholecystitis without obstruction
Applicable To
- Choledocholithiasis
Excludes
- Chronic cholecystitis
Clinical Validation Requirements
- Imaging showing gallstones
- Elevated liver function tests
Code-Specific Risks
- Misclassification if obstruction is present
Coding Notes
- Ensure documentation specifies the absence of obstruction.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Endoscopic retrograde cholangiopancreatography (ERCP) with removal of calculi
43264Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Endoscopic Retrograde Cholangiopancreatography to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.20.
Impact
Clinical: May lead to inappropriate procedure justification., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denials.
Mitigation Strategy
Always include a clear indication in the procedure note., Cross-check with clinical guidelines.
Impact
Reimbursement: May lead to incorrect billing and reimbursement issues., Compliance: Could result in non-compliance with coding guidelines., Data Quality: Impacts the accuracy of clinical data records.
Mitigation Strategy
Ensure documentation clearly states if calculi were removed during the procedure.
Impact
Incorrect use of modifiers can lead to audit flags.
Mitigation Strategy
Ensure proper training on modifier usage and regular audits of coding practices.
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 Endoscopic Retrograde Cholangiopancreatography, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Endoscopic Retrograde Cholangiopancreatography
Use these documentation templates to ensure complete and accurate documentation for Endoscopic Retrograde Cholangiopancreatography. These templates include all required elements for proper coding and billing.
ERCP with stone removal
Specialty: GastroenterologyRequired Elements
- Indication for procedure
- Details of stone removal
- Fluoroscopy time
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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