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ICD-10 Coding for Small Bowel Obstruction(K56.51, K56.52, K91.31)

Complete ICD-10-CM coding and documentation guide for Small Bowel Obstruction. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

SBOIntestinal Obstruction

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Related ICD-10 Code Ranges

Complete code families applicable to Small Bowel Obstruction

K56.0-K56.69Primary Range

Paralytic ileus and intestinal obstruction without hernia

This range includes codes for various types of small bowel obstructions, including those due to adhesions, gallstones, and other causes.

K91.3

Postprocedural intestinal obstruction

This range is used for coding postoperative small bowel obstructions.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
K56.51Adhesions with partial obstructionUse when documentation specifies partial obstruction due to adhesions.
  • CT scan showing partial obstruction
  • History of prior abdominal surgery
K56.52Adhesions with complete obstructionUse when documentation specifies complete obstruction due to adhesions.
  • CT scan showing complete obstruction
  • Absence of distal gas
K91.31Postprocedural intestinal obstruction, partialUse when documentation specifies partial postoperative obstruction.
  • Temporal link to recent surgery
  • CT scan showing partial obstruction

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 small bowel obstruction

Essential facts and insights about Small Bowel Obstruction

The ICD-10 code for small bowel obstruction depends on the cause and completeness, such as K56.51 for partial obstruction due to adhesions.

Primary ICD-10-CM Codes for small bowel obstruction

K56.51
Adhesions with partial obstruction
Billable Code

Decision Criteria

clinical Criteria

  • CT scan shows partial obstruction with adhesions.

Applicable To

  • Partial small bowel obstruction due to adhesions

Excludes

Clinical Validation Requirements

  • CT scan showing partial obstruction
  • History of prior abdominal surgery

Code-Specific Risks

  • Misclassification if completeness is not specified

Coding Notes

  • Ensure documentation specifies partial vs complete obstruction.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Intestinal anastomosis status

Z98.0
Use to indicate history of adhesiolysis.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Adhesions with complete obstruction

K56.52
Complete obstruction requires documentation of no passage of bowel contents.

Adhesions with partial obstruction

K56.51
Partial obstruction allows some passage of bowel contents.

Postprocedural intestinal obstruction, complete

K91.32
Complete obstruction requires documentation of no passage of bowel contents.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Small Bowel Obstruction to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K56.51.

Impact

Clinical: Misleading clinical picture affecting treatment decisions., Regulatory: Non-compliance with coding standards., Financial: Potential for incorrect billing and reimbursement.

Mitigation Strategy

Clarify terms in documentation, Educate providers on differences

Impact

Reimbursement: May lead to lower DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Decreased accuracy in clinical data reporting.

Mitigation Strategy

Query provider for specificity on partial vs complete obstruction.

Impact

Failure to specify completeness of obstruction can lead to audit findings.

Mitigation Strategy

Ensure thorough documentation of imaging and clinical 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 Small Bowel Obstruction, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Small Bowel Obstruction

Use these documentation templates to ensure complete and accurate documentation for Small Bowel Obstruction. These templates include all required elements for proper coding and billing.

Emergency Department Note

Specialty: Emergency Medicine

Required Elements

  • Patient history
  • Imaging findings
  • Obstruction completeness

Examples: Poor vs. Good Documentation

Poor Documentation Example
Abd pain, N/V. CT shows SBO. Admit.
Good Documentation Example
Acute onset cramping abdominal pain x 18hrs with obstipation. CT abdomen/pelvis with contrast demonstrates: Transition zone at terminal ileum, 4.2cm small bowel dilation proximal to obstruction, No pneumatosis. Impression: Complete adhesive SBO at terminal ileum, status post 2019 appendectomy.
Explanation
The good example provides specific imaging findings and surgical history, supporting accurate coding.

Need help with ICD-10 coding for Small Bowel Obstruction? Ask your questions below.

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