ICD-10 Coding for Lower Gastrointestinal Bleeding(K57.31, K55.21, K62.5)
Complete ICD-10-CM coding and documentation guide for Lower Gastrointestinal Bleeding. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lower Gastrointestinal Bleeding
K55-K64Primary Range
Diseases of the intestines and perianal region
This range includes conditions that commonly cause lower GI bleeding, such as diverticulosis and hemorrhoids.
Diseases of the blood and blood-forming organs
This range includes codes for complications like anemia due to blood loss.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K57.31 | Diverticulosis of large intestine with perforation and abscess with bleeding | Use when diverticulosis is confirmed as the source of bleeding. |
|
| K55.21 | Angiodysplasia of colon with hemorrhage | Use when angiodysplasia is confirmed as the source of bleeding. |
|
| K62.5 | Hemorrhage of anus and rectum | Use for isolated rectal bleeding without a confirmed source. |
|
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 lower gastrointestinal bleeding
Essential facts and insights about Lower Gastrointestinal Bleeding
Primary ICD-10-CM Codes for lower gastrointestinal bleeding
Decision Criteria
clinical Criteria
- Colonoscopy confirms diverticular bleeding
documentation Criteria
- Detailed description of bleeding source and symptoms
Applicable To
- Diverticular disease with bleeding
Excludes
- Diverticulitis without bleeding
Clinical Validation Requirements
- Colonoscopy confirming diverticular bleeding
- Documentation of hematochezia
Code-Specific Risks
- Misclassification if bleeding source is not confirmed
Coding Notes
- Ensure documentation specifies the location and cause of bleeding.
K55.21 - Angiodysplasia of colon with hemorrhage
Use when angiodysplasia is confirmed as the source of bleeding.
Applicable To
- Arteriovenous malformation with bleeding
Excludes
- Angiodysplasia without bleeding
Clinical Validation Requirements
- Endoscopy confirming angiodysplasia
- Documentation of hematochezia
Coding Notes
Ensure documentation specifies the location and cause of bleeding.
K62.5 - Hemorrhage of anus and rectum
Use for isolated rectal bleeding without a confirmed source.
Applicable To
- Rectal bleeding
Excludes
- Hemorrhoids with bleeding
Clinical Validation Requirements
- Physical exam confirming rectal bleeding
- Exclusion of upper GI source
Coding Notes
Ensure documentation specifies the location and cause of bleeding.
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 Lower Gastrointestinal Bleeding to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.31.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always confirm and document the source of bleeding, Use diagnostic studies to support documentation
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use specific codes like K57.31 or K55.21 when the source is known.
Impact
High risk of audit if unspecified codes are used when specific codes are applicable.
Mitigation Strategy
Ensure thorough documentation and use specific codes when the source is identified.
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 Lower Gastrointestinal Bleeding, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lower Gastrointestinal Bleeding
Use these documentation templates to ensure complete and accurate documentation for Lower Gastrointestinal Bleeding. These templates include all required elements for proper coding and billing.
Acute Lower GI Bleeding
Specialty: GastroenterologyRequired Elements
- Onset and duration of bleeding
- Description of blood (color, consistency)
- Associated symptoms (pain, dizziness)
- Past medical history (GI surgeries, conditions)
- Medication use (anticoagulants, NSAIDs)
- Physical exam findings (vital signs, rectal exam)
- Diagnostic studies (colonoscopy, labs)
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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