ICD-10 Coding for Hematemesis(K92.0, K25.0)
Complete ICD-10-CM coding and documentation guide for Hematemesis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hematemesis
K20-K31Primary Range
Diseases of esophagus, stomach and duodenum
This range includes conditions that can cause hematemesis, such as ulcers and varices.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K92.0 | Hematemesis | Use when no specific cause of hematemesis is identified. |
|
| K25.0 | Acute gastric ulcer with hemorrhage | Use when hematemesis is due to a confirmed bleeding gastric ulcer. |
|
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 hematemesis
Essential facts and insights about Hematemesis
Primary ICD-10-CM Codes for hematemesis
Decision Criteria
clinical Criteria
- No specific cause identified after diagnostic workup.
coding Criteria
- Avoid if a more specific code is applicable.
Applicable To
- Coffee ground vomiting
- Vomit containing blood
Clinical Validation Requirements
- Documentation of vomiting blood
- No identified source after workup
Code-Specific Risks
- Using K92.0 when a more specific code is available
Coding Notes
- Ensure no specific etiology is documented before using K92.0.
K25.0 - Acute gastric ulcer with hemorrhage
Use when hematemesis is due to a confirmed bleeding gastric ulcer.
Applicable To
- Bleeding gastric ulcer
Excludes
- Chronic gastric ulcer with hemorrhage (K25.4)
Clinical Validation Requirements
- Endoscopic confirmation of bleeding ulcer
- Documentation of hematemesis
Coding Notes
Ensure endoscopic confirmation is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute posthemorrhagic anemia
D62Differential 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 Hematemesis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K92.0.
Impact
Clinical: Lack of specificity can lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement due to incorrect coding.
Mitigation Strategy
Always specify upper or lower GI source, Include diagnostic findings
Impact
Reimbursement: Incorrect DRG assignment may reduce reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use the specific code for the documented cause, such as K25.0 for gastric ulcer.
Impact
Using K92.0 when a specific cause is documented.
Mitigation Strategy
Ensure thorough review of clinical documentation 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 Hematemesis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hematemesis
Use these documentation templates to ensure complete and accurate documentation for Hematemesis. These templates include all required elements for proper coding and billing.
Acute upper GI bleed
Specialty: GastroenterologyRequired Elements
- Volume and color of emesis
- Endoscopic findings
- Hemoglobin levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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