ICD-10 Coding for Gastric Nodule(K31.89, D13.1, C16.x)
Complete ICD-10-CM coding and documentation guide for Gastric Nodule. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gastric Nodule
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K31.89 | Other specified diseases of stomach | Use for nodules with nonspecific histology or when awaiting biopsy results. |
|
| D13.1 | Benign neoplasm of stomach | Use for histologically confirmed benign gastric tumors. |
|
| C16.x | Malignant neoplasm of stomach | Use for biopsy-proven malignant gastric tumors. |
|
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 gastric nodule
Essential facts and insights about Gastric Nodule
Primary ICD-10-CM Codes for gastric nodule
Decision Criteria
clinical Criteria
- Nodule observed with nonspecific histology.
documentation Criteria
- Awaiting biopsy results.
Applicable To
- Gastric nodule, unspecified
Excludes
- Malignant neoplasm of stomach (C16.x)
Clinical Validation Requirements
- EUS findings of a nodule without specific histology
- Awaiting biopsy results
Code-Specific Risks
- Risk of under-coding if malignancy is confirmed later.
Coding Notes
- Ensure documentation includes specific location and size of the nodule.
D13.1 - Benign neoplasm of stomach
Use for histologically confirmed benign gastric tumors.
Applicable To
- GIST <2 cm without high-risk features
Excludes
- Malignant neoplasm of stomach (C16.x)
Clinical Validation Requirements
- Histologically confirmed benign tumor
- EUS-guided FNA confirms leiomyoma
Coding Notes
Document histology explicitly (e.g., ‘GIST confirmed by CD117+ staining’).
C16.x - Malignant neoplasm of stomach
Use for biopsy-proven malignant gastric tumors.
Applicable To
- Adenocarcinoma of gastric antrum
Excludes
- Benign neoplasm of stomach (D13.1)
Clinical Validation Requirements
- Biopsy-proven adenocarcinoma
- CT evidence of perigastric infiltration
Coding Notes
Ensure documentation includes biopsy confirmation and tumor location.
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 Gastric Nodule to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K31.89.
Impact
Clinical: May lead to misdiagnosis or delayed treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Ensure detailed endoscopy reports., Include EUS findings and biopsy results.
Impact
Reimbursement: Incorrect coding may lead to lower reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data for clinical and research purposes.
Mitigation Strategy
Use D13.1 for histologically confirmed benign tumors.
Impact
Frequent use of unspecified codes like K31.89 without supporting documentation.
Mitigation Strategy
Ensure biopsy and imaging results are documented before coding.
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 Gastric Nodule, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gastric Nodule
Use these documentation templates to ensure complete and accurate documentation for Gastric Nodule. These templates include all required elements for proper coding and billing.
Endoscopic Evaluation of Gastric Nodule
Specialty: GastroenterologyRequired Elements
- Location
- Size
- Morphology
- EUS Features
- Biopsy Results
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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