ICD-10 Coding for Sialadenitis(K11.2, K11.5)
Complete ICD-10-CM coding and documentation guide for Sialadenitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sialadenitis
K11.2-K11.5Primary Range
Diseases of salivary glands
This range includes codes for sialadenitis and related conditions such as sialolithiasis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K11.2 | Sialadenitis | Use for acute or chronic inflammation of salivary glands without obstruction. |
|
| K11.5 | Sialolithiasis | Use when a stone is causing obstruction in the salivary gland. |
|
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 sialadenitis
Essential facts and insights about Sialadenitis
Primary ICD-10-CM Codes for sialadenitis
Decision Criteria
clinical Criteria
- Presence of purulent discharge and swelling
documentation Criteria
- Specify gland and laterality
Applicable To
- Acute sialadenitis
- Chronic sialadenitis
Clinical Validation Requirements
- Pain, swelling, erythema in salivary gland
- Purulent discharge
- Fever
- Elevated CRP/WBC
Code-Specific Risks
- Confusing acute vs. chronic sialadenitis
- Not documenting laterality
Coding Notes
- Ensure documentation specifies gland involved and whether the condition is acute or chronic.
K11.5 - Sialolithiasis
Use when a stone is causing obstruction in the salivary gland.
Applicable To
- Salivary gland stone
Excludes
- Sialadenitis without obstruction (K11.2)
Clinical Validation Requirements
- Colicky pain post-prandially
- Palpable stone on exam
- Ductal dilation on imaging
Coding Notes
Document imaging findings confirming stone presence.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Sjögren syndrome
M35.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Sialadenitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K11.2.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always confirm with imaging before coding., Include imaging results in documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies the duration and recurrence of symptoms.
Impact
Failure to sequence K11.5 before K11.2 when a stone causes obstruction.
Mitigation Strategy
Review coding guidelines for sequencing rules.
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 Sialadenitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sialadenitis
Use these documentation templates to ensure complete and accurate documentation for Sialadenitis. These templates include all required elements for proper coding and billing.
Acute sialadenitis with stone obstruction
Specialty: ENTRequired Elements
- Onset and duration of symptoms
- Gland involved and laterality
- Presence of purulent discharge
- Imaging findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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