ICD-10 Coding for Esophagitis(K20.0, K21.0)
Complete ICD-10-CM coding and documentation guide for Esophagitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Esophagitis
K20-K22Primary Range
Diseases of esophagus
This range includes all conditions related to esophageal inflammation and disorders, including esophagitis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K20.0 | Eosinophilic esophagitis | Use when biopsy confirms eosinophilic infiltration and GERD is ruled out. |
|
| K21.0 | Gastro-esophageal reflux disease with esophagitis | Use when GERD is confirmed with esophageal erosions. |
|
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 eosinophilic esophagitis
Essential facts and insights about Esophagitis
Primary ICD-10-CM Codes for esophagitis
Decision Criteria
clinical Criteria
- Biopsy confirms eosinophilic infiltration.
Applicable To
- Eosinophilic infiltration of the esophagus
Excludes
- GERD with esophagitis (K21.0)
Clinical Validation Requirements
- Biopsy showing ≥15 eosinophils per high-power field
Code-Specific Risks
- Misidentifying GERD-related esophagitis as eosinophilic esophagitis.
Coding Notes
- Ensure biopsy results are documented to support eosinophilic esophagitis.
K21.0 - Gastro-esophageal reflux disease with esophagitis
Use when GERD is confirmed with esophageal erosions.
Applicable To
- GERD with esophageal erosions
Excludes
- Eosinophilic esophagitis (K20.0)
Clinical Validation Requirements
- Endoscopy showing erosions or mucosal breaks
Coding Notes
Ensure endoscopy findings are documented to support GERD with esophagitis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Esophagitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K20.0.
Impact
Clinical: Inaccurate treatment plans., Regulatory: Potential for coding audits., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Always specify the type of esophagitis in documentation., Use endoscopy and biopsy results to guide documentation.
Impact
Reimbursement: Incorrect DRG assignment leading to reimbursement issues., Compliance: Potential for audit discrepancies., Data Quality: Misleading clinical data on GERD prevalence.
Mitigation Strategy
Use K21.9 for GERD without erosions.
Impact
Coding GERD with esophagitis without confirming erosions.
Mitigation Strategy
Require endoscopy reports for all GERD with esophagitis codes.
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 Esophagitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Esophagitis
Use these documentation templates to ensure complete and accurate documentation for Esophagitis. These templates include all required elements for proper coding and billing.
Eosinophilic Esophagitis Diagnosis
Specialty: GastroenterologyRequired Elements
- Patient history
- Endoscopy findings
- Biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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