ICD-10 Coding for Perirectal Mass(K61.0, K62.89, C20)
Complete ICD-10-CM coding and documentation guide for Perirectal Mass. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Perirectal Mass
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K61.0 | Perirectal abscess | Use when there is a confirmed abscess in the perirectal region. |
|
| K62.89 | Other specified disorders of anus and rectum | Use for non-abscess masses in the perirectal area. |
|
| C20 | Malignant neoplasm of rectum | Use for confirmed malignant tumors in the rectal area. |
|
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 perirectal abscess
Essential facts and insights about Perirectal Mass
Primary ICD-10-CM Codes for perirectal mass
Decision Criteria
clinical Criteria
- Presence of a fluctuant mass with purulent drainage in the perirectal area.
Applicable To
- Localized pus collection in perirectal region
Excludes
- Perianal abscess (K61.3)
Clinical Validation Requirements
- Fluctuant mass
- Purulent drainage
- Culture results
Code-Specific Risks
- Confusion with perianal abscess coding
Coding Notes
- Ensure documentation specifies the exact location and characteristics of the abscess.
K62.89 - Other specified disorders of anus and rectum
Use for non-abscess masses in the perirectal area.
Applicable To
- Non-abscess masses such as cysts
Excludes
- Malignant neoplasms (C20-C21)
Clinical Validation Requirements
- Solid mass
- Imaging characteristics
Coding Notes
Document imaging findings to support the diagnosis.
C20 - Malignant neoplasm of rectum
Use for confirmed malignant tumors in the rectal area.
Applicable To
- Biopsy-proven adenocarcinoma
Excludes
- Benign neoplasms (D12.8)
Clinical Validation Requirements
- Biopsy results
- TNM staging
Coding Notes
Ensure biopsy and staging documentation are complete.
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 Perirectal Mass to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K61.0.
Impact
Clinical: Inadequate treatment planning, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure culture results are documented in the patient's chart, Review documentation before coding
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Verify the exact anatomical location in the documentation.
Impact
High audit risk if culture results are not documented for abscess coding.
Mitigation Strategy
Ensure all culture results are documented and linked to the appropriate codes.
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 Perirectal Mass, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Perirectal Mass
Use these documentation templates to ensure complete and accurate documentation for Perirectal Mass. These templates include all required elements for proper coding and billing.
Perirectal abscess with drainage
Specialty: SurgeryRequired Elements
- Location and size of abscess
- Drainage procedure details
- Culture results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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