ICD-10 Coding for Malabsorption(K90.9, K90.4)
Complete ICD-10-CM coding and documentation guide for Malabsorption. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Malabsorption
K90-K91Primary Range
Diseases of the digestive system, specifically malabsorption syndromes
This range includes all codes related to malabsorption conditions, including specific causes and unspecified malabsorption.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K90.9 | Intestinal malabsorption, unspecified | Use when the specific cause of malabsorption is unknown or not documented. |
|
| K90.4 | Malabsorption due to intolerance | Use when malabsorption is due to a specific food intolerance, excluding lactose. |
|
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 malabsorption
Essential facts and insights about Malabsorption
Primary ICD-10-CM Codes for malabsorption
Decision Criteria
clinical Criteria
- Presence of chronic diarrhea and weight loss with no identified cause.
Clinical Validation Requirements
- Abnormal D-xylose test
- Stool fat >7g/day
Code-Specific Risks
- Risk of under-documentation if specific cause is known but not recorded.
Coding Notes
- Ensure documentation supports the use of an unspecified code by confirming no specific etiology is identified.
K90.4 - Malabsorption due to intolerance
Use when malabsorption is due to a specific food intolerance, excluding lactose.
Applicable To
- Non-celiac gluten sensitivity
Excludes
- Lactose intolerance (E73.-)
Clinical Validation Requirements
- Negative celiac serology
- Symptom resolution on gluten-free diet
Coding Notes
Ensure intolerance is clearly documented and differentiated from celiac disease.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential 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 Malabsorption to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K90.9.
Impact
Clinical: Inaccurate assessment of patient condition., Regulatory: Potential for audit failure., Financial: Loss of appropriate reimbursement.
Mitigation Strategy
Use standardized templates for documentation., Regular training on documentation requirements.
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts the accuracy of clinical data.
Mitigation Strategy
Select a more specific code if the cause of malabsorption is known.
Impact
Audits may target cases where severe malnutrition is coded without supporting documentation.
Mitigation Strategy
Ensure thorough documentation of clinical indicators and lab results.
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 Malabsorption, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Malabsorption
Use these documentation templates to ensure complete and accurate documentation for Malabsorption. These templates include all required elements for proper coding and billing.
Chronic malabsorption with severe malnutrition
Specialty: GastroenterologyRequired Elements
- Weight loss percentage
- Stool fat analysis
- Serum albumin levels
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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