ICD-10 Coding for Gallbladder Syndrome(K80.00, K80.20)
Complete ICD-10-CM coding and documentation guide for Gallbladder Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gallbladder Syndrome
K80-K82Primary Range
Diseases of gallbladder
This range includes codes for gallstones, cholecystitis, and other gallbladder disorders.
Right upper quadrant pain
Used to document symptoms associated with gallbladder conditions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K80.00 | Calculus of gallbladder with acute cholecystitis without obstruction | Use when acute cholecystitis is confirmed with gallstones present. |
|
| K80.20 | Calculus of gallbladder without cholecystitis | Use when gallstones are present without cholecystitis. |
|
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 gallbladder syndrome
Essential facts and insights about Gallbladder Syndrome
Primary ICD-10-CM Codes for gallbladder syndrome
Decision Criteria
clinical Criteria
- Presence of gallstones on imaging and acute symptoms.
Applicable To
- Acute cholecystitis with gallstones
Excludes
- Chronic cholecystitis (K81.1)
Clinical Validation Requirements
- Ultrasound showing gallstones
- Elevated WBC >11,000
- Positive Murphy's sign
Code-Specific Risks
- Misclassification if stones are not confirmed via imaging.
Coding Notes
- Ensure documentation specifies acute inflammation and presence of stones.
K80.20 - Calculus of gallbladder without cholecystitis
Use when gallstones are present without cholecystitis.
Applicable To
- Gallstones without inflammation
Excludes
- Acute cholecystitis (K80.00)
Clinical Validation Requirements
- Imaging confirming gallstones without signs of inflammation.
Coding Notes
Ensure documentation confirms absence of inflammation.
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 Gallbladder Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K80.00.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Increases risk of audit discrepancies., Financial: Potential for denied claims.
Mitigation Strategy
Use specific clinical terms., Ensure all symptoms are well-documented.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Increases risk of audit failures., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Always confirm the presence of stones and inflammation to use specific codes.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Ensure all documentation supports the specificity of the code used.
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 Gallbladder Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gallbladder Syndrome
Use these documentation templates to ensure complete and accurate documentation for Gallbladder Syndrome. These templates include all required elements for proper coding and billing.
Acute Cholecystitis with Gallstones
Specialty: GastroenterologyRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Laboratory findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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