ICD-10 Coding for Esophageal Ulcer(K22.10, K22.11)
Complete ICD-10-CM coding and documentation guide for Esophageal Ulcer. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Esophageal Ulcer
K22.1-K22.11Primary Range
Diseases of esophagus, including esophageal ulcer
This range includes codes specific to esophageal ulcers, with and without bleeding.
Mental and behavioral disorders due to use of alcohol
Used when alcohol use contributes to the esophageal ulcer.
Viral infections causing esophagitis
Used for viral causes of esophageal ulcers, such as CMV or HSV.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K22.10 | Ulcer of esophagus without bleeding | Use when an esophageal ulcer is confirmed without bleeding. |
|
| K22.11 | Ulcer of esophagus with bleeding | Use when an esophageal ulcer is confirmed with bleeding. |
|
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 esophageal ulcer with bleeding
Essential facts and insights about Esophageal Ulcer
Primary ICD-10-CM Codes for esophageal ulcer
Decision Criteria
clinical Criteria
- Endoscopy shows ulcer without bleeding
Applicable To
- Esophageal ulcer without bleeding
Excludes
- Esophageal ulcer with bleeding (K22.11)
Clinical Validation Requirements
- Endoscopic confirmation of esophageal ulcer without active bleeding
Code-Specific Risks
- Misclassification if bleeding is present but not documented
Coding Notes
- Ensure documentation specifies absence of bleeding.
K22.11 - Ulcer of esophagus with bleeding
Use when an esophageal ulcer is confirmed with bleeding.
Applicable To
- Esophageal ulcer with bleeding
Clinical Validation Requirements
- Endoscopic findings of bleeding ulcer
- Documentation of hematemesis or melena
Coding Notes
Document the source of bleeding clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Esophageal Ulcer to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K22.10.
Impact
Clinical: Misrepresentation of patient condition, Regulatory: Potential audit risk, Financial: Incorrect reimbursement
Mitigation Strategy
Ensure endoscopy findings are detailed, Verify documentation before coding
Impact
Reimbursement: Incorrect DRG assignment, potential underpayment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Use K22.11 if bleeding is documented.
Impact
Inadequate documentation of bleeding can lead to audit issues.
Mitigation Strategy
Ensure detailed endoscopy reports are included in the patient record.
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 Esophageal Ulcer, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Esophageal Ulcer
Use these documentation templates to ensure complete and accurate documentation for Esophageal Ulcer. These templates include all required elements for proper coding and billing.
Esophageal ulcer with bleeding
Specialty: GastroenterologyRequired Elements
- Endoscopy findings
- Bleeding status
- Etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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