ICD-10 Coding for Esophageal Stricture/Stenosis(K22.2, K21.0)
Complete ICD-10-CM coding and documentation guide for Esophageal Stricture/Stenosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Esophageal Stricture/Stenosis
K20-K31Primary Range
Diseases of esophagus, stomach and duodenum
This range includes codes for various esophageal conditions, including strictures and stenosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K22.2 | Esophageal obstruction | Use when there is a confirmed mechanical narrowing of the esophagus. |
|
| K21.0 | Gastro-esophageal reflux disease with esophagitis | Use as primary when stricture is due to GERD. |
|
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 esophageal stricture
Essential facts and insights about Esophageal Stricture/Stenosis
Primary ICD-10-CM Codes for stricture and stenosis of esophagus
Decision Criteria
clinical Criteria
- Endoscopic confirmation of esophageal narrowing
Applicable To
- Peptic stricture
- Post-surgical stenosis
Excludes
- Congenital esophageal stenosis (Q39.3)
Clinical Validation Requirements
- Endoscopic visualization of stricture
- Barium swallow showing luminal narrowing
Code-Specific Risks
- Incorrectly coding as K22.9 when stricture is confirmed
Coding Notes
- Ensure documentation specifies the location and severity of the stricture.
K21.0 - Gastro-esophageal reflux disease with esophagitis
Use as primary when stricture is due to GERD.
Applicable To
- GERD with esophagitis
Excludes
- Esophageal stricture without GERD (K22.2)
Clinical Validation Requirements
- pH study showing acid exposure
- Endoscopic evidence of esophagitis
Coding Notes
Ensure GERD is documented as the primary cause of the stricture.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Dysphagia
R13.1-Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Esophageal Stricture/Stenosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K22.2.
Impact
Clinical: Inadequate treatment planning, Regulatory: Potential audit issues, Financial: Reduced reimbursement
Mitigation Strategy
Use specific terms like 'solid-food dysphagia', Include endoscopic findings
Impact
Reimbursement: Potential underpayment due to incorrect coding, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data representation
Mitigation Strategy
Always use K22.2 if imaging or endoscopy confirms narrowing.
Impact
Failure to sequence GERD as primary when it is the cause of the stricture.
Mitigation Strategy
Review documentation to ensure GERD is noted as the primary cause when applicable.
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 Esophageal Stricture/Stenosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Esophageal Stricture/Stenosis
Use these documentation templates to ensure complete and accurate documentation for Esophageal Stricture/Stenosis. These templates include all required elements for proper coding and billing.
Refractory esophageal stricture
Specialty: GastroenterologyRequired Elements
- Endoscopy findings
- Biopsy results
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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