ICD-10 Coding for Hypertensive Portal Gastropathy(K76.6, K31.88)
Complete ICD-10-CM coding and documentation guide for Hypertensive Portal Gastropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypertensive Portal Gastropathy
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K76.6 | Portal hypertension | Use when portal hypertension is confirmed as the underlying condition. |
|
| K31.88 | Other specified diseases of stomach and duodenum | Use as a secondary code when portal hypertensive gastropathy is documented. |
|
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: How is hypertensive portal gastropathy coded?
Essential facts and insights about Hypertensive Portal Gastropathy
Primary ICD-10-CM Codes for hypertensive portal gastropathy
Decision Criteria
clinical Criteria
- Confirmed portal hypertension with endoscopic findings of gastropathy
Applicable To
- Portal hypertension due to cirrhosis
Excludes
- Esophageal varices without bleeding (I85.00)
Clinical Validation Requirements
- Cirrhosis confirmed by imaging or biopsy
- Presence of varices or ascites
- Elevated hepatic venous pressure gradient (HVPG)
Code-Specific Risks
- Incorrectly coding as primary without evidence of portal hypertension
K31.88 - Other specified diseases of stomach and duodenum
Use as a secondary code when portal hypertensive gastropathy is documented.
Applicable To
- Portal hypertensive gastropathy
Excludes
- Gastric antral vascular ectasia (GAVE) (K31.89)
Clinical Validation Requirements
- Endoscopic findings of mosaic pattern or snake-skin appearance
- Absence of inflammation or H. pylori infection
Coding Notes
Document endoscopic findings clearly to differentiate from other gastropathies.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified diseases of stomach and duodenum
K31.88Differential 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 Hypertensive Portal Gastropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K76.6.
Impact
Clinical: Leads to misdiagnosis and inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to lack of specificity.
Mitigation Strategy
Educate providers on the importance of specifying gastropathy type., Implement checklist for endoscopic documentation.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement issues., Compliance: Non-compliance with ICD-10 sequencing rules., Data Quality: Inaccurate representation of patient's clinical condition.
Mitigation Strategy
Always code portal hypertension (K76.6) first, as PHG is a manifestation.
Impact
Reimbursement: Incorrect coding can affect reimbursement rates., Compliance: Potential audit risk due to misclassification., Data Quality: Impacts clinical data accuracy and patient records.
Mitigation Strategy
Differentiate based on endoscopic findings and location.
Impact
Failure to sequence portal hypertension before gastropathy.
Mitigation Strategy
Educate coding staff on proper sequencing rules.
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 Hypertensive Portal Gastropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypertensive Portal Gastropathy
Use these documentation templates to ensure complete and accurate documentation for Hypertensive Portal Gastropathy. These templates include all required elements for proper coding and billing.
Gastroenterology Progress Note
Specialty: GastroenterologyRequired Elements
- Endoscopic findings
- Linkage to portal hypertension
- Cirrhosis status
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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