ICD-10 Coding for Radiation Proctitis(K62.7, N30.4X)
Complete ICD-10-CM coding and documentation guide for Radiation Proctitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Radiation Proctitis
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K62.7 | Radiation proctitis | Use when the patient has confirmed proctitis due to radiation exposure. |
|
| N30.4X | Radiation cystitis | Use when bladder symptoms are predominant. |
|
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 radiation proctitis
Essential facts and insights about Radiation Proctitis
Primary ICD-10-CM Codes for radiation proctitis
Decision Criteria
clinical Criteria
- Presence of rectal bleeding and history of radiation
Applicable To
- Proctitis due to radiation therapy
Excludes
- Radiation cystitis (N30.4X)
Clinical Validation Requirements
- History of pelvic radiation
- Endoscopic findings such as mucosal atrophy or telangiectasia
Code-Specific Risks
- Claims may be denied if not linked with radiation exposure code W90.-
Coding Notes
- Ensure documentation includes radiation type and dose.
N30.4X - Radiation cystitis
Use when bladder symptoms are predominant.
Applicable To
- Cystitis due to radiation therapy
Excludes
- Radiation proctitis (K62.7)
Clinical Validation Requirements
- Bladder symptoms such as urgency or frequency
- History of pelvic radiation
Coding Notes
Ensure bladder symptoms are documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Exposure to external beam radiation
W90.2XXADocumentation & Coding Risks
Avoid these common documentation and coding issues when documenting Radiation Proctitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K62.7.
Impact
Clinical: Misleading clinical picture., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document radiation history., Verify endoscopic findings.
Impact
Reimbursement: Claims may be denied without proper linkage., Compliance: Non-compliance with coding guidelines., Data Quality: Incomplete data on radiation exposure.
Mitigation Strategy
Always include W90.- to specify radiation exposure.
Impact
Lack of detailed radiation history can lead to audit issues.
Mitigation Strategy
Ensure comprehensive documentation of radiation therapy.
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 Radiation Proctitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Radiation Proctitis
Use these documentation templates to ensure complete and accurate documentation for Radiation Proctitis. These templates include all required elements for proper coding and billing.
Chronic radiation proctitis management
Specialty: GastroenterologyRequired Elements
- Radiation history
- Endoscopic findings
- Symptom duration
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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