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:
Related ICD-10 Code Ranges
Complete code families applicable to Hematochezia
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K92.2 | Gastrointestinal hemorrhage, unspecified | Use when the source of bleeding is not confirmed and no specific cause is documented. |
|
| K62.5 | Hemorrhage of anus and rectum | Use when bleeding is confirmed to be from the anus or rectum. |
|
| K57.31 | Diverticulosis of large intestine with perforation and abscess with bleeding | Use when diverticulosis with bleeding is confirmed via imaging or endoscopy. |
|
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
Primary ICD-10-CM Codes for hematochezia
Decision Criteria
clinical Criteria
- Presence of bright red blood per rectum with no upper GI source.
Applicable To
- Unspecified GI bleeding
Excludes
- Melena (K92.1)
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.
K62.5 - Hemorrhage of anus and rectum
Use when bleeding is confirmed to be from the anus or rectum.
Applicable To
- Bleeding from hemorrhoids
Excludes
- Rectal prolapse with bleeding (K62.3)
Clinical Validation Requirements
- Visual confirmation of hemorrhoids or fissure
- Bright red blood on stool surface
Coding Notes
Ensure documentation specifies the source of bleeding to avoid miscoding.
K57.31 - Diverticulosis of large intestine with perforation and abscess with bleeding
Use when diverticulosis with bleeding is confirmed via imaging or endoscopy.
Applicable To
- Diverticular bleeding
Excludes
- Diverticulitis without bleeding (K57.30)
Clinical Validation Requirements
- Colonoscopy showing active diverticular bleeding
Coding Notes
Ensure bleeding is documented as related to diverticulosis.
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)
D50.0Differential 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 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 MedicineRequired Elements
- History of Present Illness
- Physical Examination
- Imaging Results
- Assessment and Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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