ICD-10 Coding for Odynophagia(K20.0, B37.0, R07.1)
Complete ICD-10-CM coding and documentation guide for Odynophagia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Odynophagia
K20-K31Primary Range
Diseases of esophagus, stomach and duodenum
Includes conditions like esophagitis and GERD, which are common causes of odynophagia.
Symptoms and signs involving the circulatory and respiratory systems
Includes symptom codes like R07.1 for chest pain on swallowing, used when the underlying cause is not identified.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K20.0 | Eosinophilic esophagitis | Use when eosinophilic esophagitis is confirmed as the cause of odynophagia. |
|
| B37.0 | Candidal esophagitis | Use when candidal infection is confirmed as the cause of odynophagia. |
|
| R07.1 | Chest pain on swallowing | Use when odynophagia is present and the underlying cause is not identified. |
|
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 odynophagia
Essential facts and insights about Odynophagia
Primary ICD-10-CM Codes for odynophagia
Decision Criteria
clinical Criteria
- Biopsy confirmation of eosinophilic infiltration
Applicable To
- Eosinophilic esophagitis with odynophagia
Excludes
- Other types of esophagitis
Clinical Validation Requirements
- Confirmed by esophageal biopsy showing ≥15 eosinophils/HPF
Code-Specific Risks
- Misclassification if biopsy results are not available.
Coding Notes
- Ensure biopsy confirmation before using K20.0.
B37.0 - Candidal esophagitis
Use when candidal infection is confirmed as the cause of odynophagia.
Applicable To
- Candidal esophagitis with odynophagia
Excludes
- Other fungal infections
Clinical Validation Requirements
- Positive fungal culture or biopsy
Coding Notes
Confirm candidal infection through culture or biopsy.
R07.1 - Chest pain on swallowing
Use when odynophagia is present and the underlying cause is not identified.
Applicable To
- Odynophagia
Excludes
- Dysphagia (R13.1-)
Clinical Validation Requirements
- Patient reports pain specifically during swallowing
Coding Notes
Ensure documentation specifies pain during swallowing.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Chest pain on swallowing
R07.1Differential 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 Odynophagia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K20.0.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Always include diagnostic findings., Use specific terminology for underlying conditions.
Impact
Reimbursement: May result in lower reimbursement if symptom code is primary., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use symptom code R07.1 and code the underlying cause if known.
Impact
Using symptom codes as primary without identifying the underlying cause.
Mitigation Strategy
Ensure thorough documentation of diagnostic tests and findings.
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 Odynophagia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Odynophagia
Use these documentation templates to ensure complete and accurate documentation for Odynophagia. These templates include all required elements for proper coding and billing.
Gastroenterology Progress Note
Specialty: GastroenterologyRequired Elements
- Assessment of esophageal condition
- Biopsy results
- Symptom description
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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