ICD-10 Coding for Gallstone(K80.0, K80.10, K80.20, K80.3)
Complete ICD-10-CM coding and documentation guide for Gallstone. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gallstone
K80.0-K80.3Primary Range
Cholelithiasis with various complications
This range covers gallstones with different types of inflammation and 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 |
|---|---|---|---|
| K80.0 | Calculus of gallbladder with acute cholecystitis | Use when acute cholecystitis is confirmed with imaging and lab findings. |
|
| K80.10 | Calculus of gallbladder with chronic cholecystitis | Use when chronic cholecystitis is confirmed by histopathology. |
|
| K80.20 | Calculus of gallbladder with acute and chronic cholecystitis | Use when both acute and chronic inflammation are documented. |
|
| K80.3 | Calculus of gallbladder with obstruction | Use when obstruction is confirmed by imaging. |
|
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 gallstones with acute cholecystitis
Essential facts and insights about Gallstone
Primary ICD-10-CM Codes for gall stone
Decision Criteria
clinical Criteria
- Acute RUQ pain with elevated WBC and ultrasound findings
Applicable To
- Gallstones with acute inflammation
Excludes
- Chronic cholecystitis without gallstones
Clinical Validation Requirements
- RUQ pain
- WBC >11,000
- Ultrasound showing wall thickening >4mm
Code-Specific Risks
- Misdiagnosis if acute inflammation is not confirmed
Coding Notes
- Ensure documentation specifies acute inflammation.
K80.10 - Calculus of gallbladder with chronic cholecystitis
Use when chronic cholecystitis is confirmed by histopathology.
Applicable To
- Gallstones with chronic inflammation
Excludes
- Acute cholecystitis without gallstones
Clinical Validation Requirements
- Histology showing fibrosis
- Recurrent episodes
Coding Notes
Documentation must specify chronic inflammation.
K80.20 - Calculus of gallbladder with acute and chronic cholecystitis
Use when both acute and chronic inflammation are documented.
Applicable To
- Gallstones with both acute and chronic inflammation
Excludes
- Cholecystitis without gallstones
Clinical Validation Requirements
- Pathology report showing acute-on-chronic changes
Coding Notes
Ensure both acute and chronic inflammation are documented.
K80.3 - Calculus of gallbladder with obstruction
Use when obstruction is confirmed by imaging.
Applicable To
- Gallstones causing obstruction
Excludes
- Obstruction without gallstones
Clinical Validation Requirements
- Dilated CBD >8mm
- Elevated ALP >125 U/L
Coding Notes
Documentation must confirm obstruction.
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 Gallstone to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.0.
Impact
Clinical: Leads to vague clinical records., Regulatory: Increases risk of audits., Financial: Potential for denied claims.
Mitigation Strategy
Ensure detailed documentation, Use specific codes when possible
Impact
Reimbursement: May lead to denied claims if obstruction is not documented., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on gallstone complications.
Mitigation Strategy
Ensure imaging confirms obstruction before using K80.3.
Impact
Frequent use of unspecified codes can trigger audits.
Mitigation Strategy
Ensure documentation supports specific code selection.
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 Gallstone, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gallstone
Use these documentation templates to ensure complete and accurate documentation for Gallstone. These templates include all required elements for proper coding and billing.
Cholecystectomy for acute cholecystitis
Specialty: SurgeryRequired Elements
- Specimen description
- Wall thickness
- Presence of calculi
- Histopathology findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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