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ICD-10 Coding for Hematochezia(K92.2, K62.5, K57.31)

Complete ICD-10-CM coding and documentation guide for Hematochezia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Rectal bleedingLower gastrointestinal bleeding

Related ICD-10 Code Ranges

Complete code families applicable to Hematochezia

K92-K92.9Primary Range

Other diseases of digestive system

This range includes codes for gastrointestinal hemorrhage, which is relevant for hematochezia.

Diseases of anus and rectum

Includes specific codes for hemorrhage of anus and rectum, applicable when the bleeding source is identified.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
K92.2Gastrointestinal hemorrhage, unspecifiedUse when the source of bleeding is not confirmed and no specific cause is documented.
  • Negative upper endoscopy
  • No definitive source identified on imaging
K62.5Hemorrhage of anus and rectumUse when bleeding is confirmed to be from the anus or rectum.
  • Visual confirmation of hemorrhoids or fissure
  • Bright red blood on stool surface
K57.31Diverticulosis of large intestine with perforation and abscess with bleedingUse when diverticulosis with bleeding is confirmed via imaging or endoscopy.
  • Colonoscopy showing active diverticular bleeding

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 hematochezia

Essential facts and insights about Hematochezia

The ICD-10 code for unspecified gastrointestinal hemorrhage, including hematochezia, is K92.2 when the source is not identified.

Primary ICD-10-CM Codes for hematochezia

Gastrointestinal hemorrhage, unspecified
Billable Code

Decision Criteria

clinical Criteria

  • Presence of bright red blood per rectum with no upper GI source.

Applicable To

  • Unspecified GI bleeding

Excludes

Clinical Validation Requirements

  • Negative upper endoscopy
  • No definitive source identified on imaging

Code-Specific Risks

  • May lead to lower reimbursement if used without specific documentation.

Coding Notes

  • Ensure documentation excludes upper GI sources to avoid incorrect coding.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Iron deficiency anemia secondary to blood loss (chronic)

D50.0
Use when anemia is present due to chronic blood loss.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Melena

K92.1
Use K92.1 for black, tarry stools indicating upper GI bleeding.

Rectal prolapse

K62.3
Use K62.3 when rectal prolapse is the source of bleeding.

Diverticulosis of large intestine without perforation or abscess without bleeding

K57.30
Use K57.30 when there is no bleeding.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Hematochezia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K92.2.

Impact

Clinical: May lead to incorrect diagnosis of upper GI bleed., Regulatory: Could result in coding audits., Financial: Potential for reimbursement denial.

Mitigation Strategy

Ensure thorough documentation of diagnostic tests.

Impact

Reimbursement: May result in lower reimbursement., Compliance: Could trigger audits for unspecified coding., Data Quality: Reduces accuracy of clinical data.

Mitigation Strategy

Use specific codes like K62.5 or K57.31 when the source is known.

Impact

Using unspecified codes like K92.2 without proper documentation.

Mitigation Strategy

Ensure documentation specifies the source or confirms no source found.

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 Hematochezia, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Hematochezia

Use these documentation templates to ensure complete and accurate documentation for Hematochezia. These templates include all required elements for proper coding and billing.

Emergency Department Presentation

Specialty: Emergency Medicine

Required Elements

  • History of Present Illness
  • Physical Examination
  • Imaging Results
  • Assessment and Plan

Example Documentation

68M with acute onset hematochezia. Blood bright red, mixed with stool. No melena. CT angiography shows contrast extravasation in descending colon.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Blood in stool.
Good Documentation Example
Bright red blood coating stool, no melena. Colonoscopy shows bleeding diverticulum.
Explanation
The good example provides specific details and links the bleeding to a documented source.

Need help with ICD-10 coding for Hematochezia? Ask your questions below.

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