ICD-10 Coding for Mallory-Weiss Tear(K22.6)
Complete ICD-10-CM coding and documentation guide for Mallory-Weiss Tear. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Mallory-Weiss Tear
K20-K31Primary Range
Diseases of esophagus, stomach and duodenum
This range includes conditions affecting the esophagus, such as Mallory-Weiss tear.
Key Information: ICD-10 code for Mallory-Weiss tear
Essential facts and insights about Mallory-Weiss Tear
Primary ICD-10-CM Code for mallory weiss tear
Decision Criteria
clinical Criteria
- Endoscopy confirms tear at gastroesophageal junction.
documentation Criteria
- Explicit mention of Mallory-Weiss tear in medical records.
Applicable To
- Mallory-Weiss syndrome with or without hemorrhage
Excludes
- Esophageal varices (I85.-)
Clinical Validation Requirements
- Endoscopy report confirming tear location/size
- Documentation of hematemesis or melena
Code-Specific Risks
- Mistakenly coding esophageal varices instead of Mallory-Weiss tear.
Coding Notes
- Ensure endoscopy findings are documented to support the diagnosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Mallory-Weiss Tear to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K22.6.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Verify endoscopy findings before coding., Ensure documentation supports the diagnosis.
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: May result in non-compliance with coding standards., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Always add K92.0 or K92.1 if there is active bleeding.
Impact
Lack of detailed endoscopy findings can trigger audits.
Mitigation Strategy
Ensure all endoscopy reports are detailed and complete.
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 Mallory-Weiss Tear, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Mallory-Weiss Tear
Use these documentation templates to ensure complete and accurate documentation for Mallory-Weiss Tear. These templates include all required elements for proper coding and billing.
Acute presentation with hematemesis
Specialty: GastroenterologyRequired Elements
- Onset and duration of vomiting
- Endoscopy results
- Intervention details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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