ICD-10 Coding for Sleeve Gastrectomy(Z98.84, K91.89)
Complete ICD-10-CM coding and documentation guide for Sleeve Gastrectomy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sleeve Gastrectomy
Z98-Z99Primary Range
Persons with potential health hazards related to family and personal history and certain conditions influencing health status
Includes codes for post-procedural status, such as Z98.84 for bariatric surgery status.
Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classified
Includes codes for complications following digestive system procedures, such as K91.89 for other postprocedural complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| Z98.84 | Bariatric surgery status | Use when documenting the patient's history of bariatric surgery without current complications. |
|
| K91.89 | Other postprocedural complications and disorders of digestive system | Use when there are documented complications following sleeve gastrectomy. |
|
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 sleeve gastrectomy
Essential facts and insights about Sleeve Gastrectomy
Primary ICD-10-CM Codes for sleeve gastrectomy
Decision Criteria
clinical Criteria
- Patient has undergone sleeve gastrectomy with no current complications.
Applicable To
- Status post sleeve gastrectomy
Excludes
- Complications of bariatric surgery (K91.89)
Clinical Validation Requirements
- Documented history of bariatric surgery
- No current complications
Code-Specific Risks
- Incorrectly using for active complications
Coding Notes
- Ensure no active complications are present when using Z98.84.
K91.89 - Other postprocedural complications and disorders of digestive system
Use when there are documented complications following sleeve gastrectomy.
Applicable To
- Post-sleeve gastrectomy stricture
Excludes
- Status post bariatric surgery without complications (Z98.84)
Clinical Validation Requirements
- Documented postprocedural complication such as stricture or leak
Coding Notes
Ensure documentation supports the presence of a complication.
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 Sleeve Gastrectomy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z98.84.
Impact
Clinical: Inadequate assessment of obesity severity., Regulatory: Non-compliance with insurance requirements., Financial: Potential claim denials.
Mitigation Strategy
Standardize BMI documentation in templates, Educate staff on importance of BMI recording
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Use K91.89 for any active complications post-surgery.
Impact
Failure to document comorbidities can lead to audit findings.
Mitigation Strategy
Ensure thorough documentation of all comorbid conditions.
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 Sleeve Gastrectomy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sleeve Gastrectomy
Use these documentation templates to ensure complete and accurate documentation for Sleeve Gastrectomy. These templates include all required elements for proper coding and billing.
Postoperative Follow-up
Specialty: Bariatric SurgeryRequired Elements
- Patient's current weight and BMI
- Presence or absence of complications
- Nutritional status
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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