ICD-10 Coding for Upper Gastrointestinal Bleed(K25.0, K92.0)
Complete ICD-10-CM coding and documentation guide for Upper Gastrointestinal Bleed. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Upper Gastrointestinal Bleed
K20-K31Primary Range
Diseases of esophagus, stomach, and duodenum
This range includes specific codes for conditions causing upper gastrointestinal bleeding, such as ulcers and esophagitis.
Other diseases of the digestive system
This range includes codes for unspecified gastrointestinal hemorrhage and symptoms like hematemesis and melena.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K25.0 | Acute gastric ulcer with hemorrhage | Use when endoscopy confirms a bleeding gastric ulcer. |
|
| K92.0 | Hematemesis | Use when there is vomiting of blood without a confirmed source. |
|
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 upper gastrointestinal bleeding
Essential facts and insights about Upper Gastrointestinal Bleed
Primary ICD-10-CM Codes for upper gastrointestinal bleed
Decision Criteria
clinical Criteria
- Endoscopic evidence of bleeding ulcer
documentation Criteria
- Explicit mention of bleeding ulcer in the medical record
Applicable To
- Bleeding gastric ulcer
Excludes
- Chronic gastric ulcer with hemorrhage (K25.4)
Clinical Validation Requirements
- Endoscopic confirmation of bleeding ulcer
- Documentation of active bleeding or visible vessel
Code-Specific Risks
- Misclassification if bleeding is not confirmed endoscopically
Coding Notes
- Ensure endoscopic findings are documented to support the code.
K92.0 - Hematemesis
Use when there is vomiting of blood without a confirmed source.
Applicable To
- Vomiting of blood
Excludes
- Hematemesis with confirmed bleeding source (e.g., gastric ulcer)
Clinical Validation Requirements
- Documentation of vomiting blood
- Absence of identified bleeding source
Coding Notes
Ensure documentation specifies vomiting of blood.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute posthemorrhagic anemia
D62Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Upper Gastrointestinal Bleed to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K25.0.
Impact
Clinical: Misrepresents patient condition., Regulatory: Non-compliance with coding standards., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Review endoscopy reports, Ensure documentation specificity
Impact
Reimbursement: May result in lower DRG payment., Compliance: Non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use specific codes like K25.0 or K26.0 when the bleeding source is confirmed.
Impact
High risk of audit if unspecified codes are used when specific codes are applicable.
Mitigation Strategy
Ensure documentation supports specific code selection.
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 Bleed, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Upper Gastrointestinal Bleed
Use these documentation templates to ensure complete and accurate documentation for Upper Gastrointestinal Bleed. These templates include all required elements for proper coding and billing.
Emergency Department Evaluation of UGIB
Specialty: Emergency MedicineRequired Elements
- Vital signs
- Hemoglobin levels
- Endoscopy results
- Risk scores
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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