ICD-10 Coding for Upper Gastrointestinal Bleeding(K92.2, K25.0, D68.32)
Complete ICD-10-CM coding and documentation guide for Upper Gastrointestinal Bleeding. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Upper Gastrointestinal Bleeding
K92.0-K92.2Primary Range
Other diseases of the digestive system
This range includes codes for unspecified gastrointestinal hemorrhage, which is often used when the specific source of bleeding is not identified.
Peptic ulcer disease with hemorrhage
These codes are used when the source of bleeding is identified as a peptic ulcer, confirmed through endoscopy.
Hemorrhagic disorders due to extrinsic circulating anticoagulants
This range is relevant when bleeding is associated with anticoagulant use, requiring explicit documentation of causation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K92.2 | Gastrointestinal hemorrhage, unspecified | Use when the source of bleeding is not identified or documented. |
|
| K25.0 | Acute gastric ulcer with hemorrhage | Use when endoscopy confirms a gastric ulcer as the source of bleeding. |
|
| D68.32 | Hemorrhagic disorder due to extrinsic circulating anticoagulants | Use when there is a documented link between anticoagulant use and bleeding. |
|
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 UGIB
Essential facts and insights about Upper Gastrointestinal Bleeding
Primary ICD-10-CM Codes for ugib
Decision Criteria
clinical Criteria
- Hematochezia or melena without identified source
Applicable To
- Unspecified gastrointestinal bleeding
Excludes
- Bleeding from specific sites (e.g., esophagus, stomach, duodenum)
Clinical Validation Requirements
- Clinical presentation of hematemesis or melena without identified source
Code-Specific Risks
- Risk of undercoding if the source of bleeding is later identified.
Coding Notes
- Ensure documentation does not specify a more precise source of bleeding.
K25.0 - Acute gastric ulcer with hemorrhage
Use when endoscopy confirms a gastric ulcer as the source of bleeding.
Applicable To
- Bleeding gastric ulcer
Excludes
- Bleeding from other sites like duodenum
Clinical Validation Requirements
- Endoscopic confirmation of gastric ulcer with active bleeding
Coding Notes
Ensure endoscopic findings are documented.
D68.32 - Hemorrhagic disorder due to extrinsic circulating anticoagulants
Use when there is a documented link between anticoagulant use and bleeding.
Applicable To
- Bleeding due to anticoagulant therapy
Excludes
- Bleeding not related to anticoagulant use
Clinical Validation Requirements
- Provider documentation linking bleeding to anticoagulant use
Coding Notes
Ensure provider documentation explicitly states causation.
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 Upper Gastrointestinal Bleeding to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K92.2.
Impact
Clinical: Misrepresentation of clinical scenario., Regulatory: Potential audit failure., Financial: Loss of appropriate reimbursement.
Mitigation Strategy
Review endoscopic reports for specific findings., Ensure provider notes specify bleeding source.
Impact
Reimbursement: Potential for incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use R11.2 for unspecified vomiting of blood and query for clarification.
Impact
High risk of audit if K92.2 is used without proper justification.
Mitigation Strategy
Ensure thorough documentation of diagnostic procedures and 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 Upper Gastrointestinal Bleeding, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Upper Gastrointestinal Bleeding
Use these documentation templates to ensure complete and accurate documentation for Upper Gastrointestinal Bleeding. These templates include all required elements for proper coding and billing.
Post-EGD Documentation
Specialty: GastroenterologyRequired Elements
- Etiology of bleeding
- Endoscopic findings
- Management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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