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ICD-10-CM Coding Guidelines - Diseases of the Digestive System (Chapter 11) and Diseases of the Skin and Subcutaneous Tissue (Chapter 12)
 
 

ICD-10-CM Coding Guidelines - Diseases of the Digestive System (Chapter 11) and Diseases of the Skin and Subcutaneous Tissue (Chapter 12)

 

Diseases of the Digestive System (Chapter 11)

Chapter 11 of ICD-10-CM is titled "Disease of the Digestive System," which includes categories K00-K94. The digestive system, or alimentary canal, is composed of the oral cavity, teeth, salivary glands, esophagus, stomach, small intestine, and colon. There are three sections of the small intestine: duodenum, jejunum, and ileum. Also, there are four sections of the colon: ascending, transverse, descending, and terminal sigmoid.

  • K00-K14 Disease of Oral Cavity and Salivary Glands – Codes in this subsection correspond with those in categories 520-529 in ICD-9-CM. Conditions in this category include those that impair one's ability to chew, those associated with poor dental hygiene, and other disorders that lead to problems with the teeth. Conditions include gingivitis, periodontal diseases, stomatitis, lip diseases, and disorders of the tongue and oral mucosa. 

  • K20-K31 Disease of Esophagus, Stomach, and Duodenum – Codes in this subsection correspond with those in categories 530-538 in ICD-9-CM. Conditions include esophageal strictures, ulcers, spasms, and perforations, diverticular disease, gastroesophageal reflux disease, pyloric stenosis, dyspepsia, gastritis, and inflammation of the gastric mucosa. 

  • K35-K38 Diseases of Appendix – Codes in this subsection correspond with those in categories 540-543 in ICD-9-CM. Conditions include acute appendicitis, chronic appendicitis, appendicular concretions, hyperplasia of appendix, diverticulum of appendix, fistula of appendix, and intussusception of appendix. 

  • K40-K46 Hernia – Codes in this subsection correspond with those in categories 550-553 in ICD-9-CM. Conditions coded include inguinal, femoral, umbilical, ventral, and diaphragmatic hernia, as well as enterocele. 

  • K50-K52 Non-Infective Enteritis and Colitis – Codes in this subsection correspond with those in categories 555, 556, and 558 in ICD-9-CM. Conditions coded include Crohn's disease, ulcerative colitis, sigmoiditis, jejunitis, ileitis, gastroenteritis, enteritis, and colitis. 

  • K55-K63 Other Disease of Intestines – Codes in this subsection correspond with those in categories 557, 560-565, and 568 in ICD-9-CM. Conditions coded include intestinal adhesions, impactions, and obstructions, constipation, diarrhea, anal and rectal spasms, fistulas, irritable bowel syndrome, fissures, abscesses, stenosis, prolapse, polyps, diverticular disease, and perforations. 

  • K65-K68 Disease of Peritoneum and Retroperitoneum – Codes in this subsection correspond with those in categories 567-568 in ICD-9-CM. Conditions coded include peritonitis, hemoperitoneum, peritoneal adhesions, disorders of the retroperitoneum, and peritoneum infections and diseases not classified elsewhere.

  • K70-K77 Disease of Liver – Codes in this subsection correspond with those in categories 570-573 in ICD-9-CM. Conditions coded include alcoholic liver disease, hepatic failure, chronic hepatitis, fatty liver, portal hypertension, liver abscess, inflammation of the liver, toxic liver disease, liver cysts, and liver abscess.

  • K80-K87 Disorders of Gallbladder, Biliary Tract, and Pancreas – Codes in this subsection correspond with those in categories 574-577 in ICD-9-CM. Conditions coded include cholelithiasis, cholecystitis, bile duct obstruction, cholangitis, ruptures, fistulas, spasms, cysts, and pancreatitis.

  • K90-K94 Other Diseases of the Digestive System – Codes in this subsection correspond with those in categories 578-579 in ICD-9-CM. Conditions coded include  pancreatic steatorrhea, celiac disease, Whipple's disease, malabsorption disorders, lacerations, punctures, structural abnormalities, and surgical complications.

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General Guidelines

  • When coding for periodontal disease, stomatitis, gingivitis, lip disease, tongue disorders, and conditions of the oral mucosa, additional codes should be sued to report documented exposure to tobacco smoke, a history of tobacco use, occupational and environmental smoke exposure, tobacco use, or tobacco dependence.

  • If a chemical, medication, or drug is listed as the causative agent for an esophageal or stomach ulcer, the code to identify the agent should be sequenced before the code to classify the ulcer (K22.1-).

  • When polyps are categorized as neoplasms, an exclusion note related to category K51.4-, which directs the coder to D12.

  • Category K65 has an extensive list of conditions with exclusion notes.

  • When reporting a disorder or condition from category K65, the coder should assign a secondary code to report the infectious agent.

  • Code K67, Disorders of the peritoneum in infectious diseases classified elsewhere, is to be used as a secondary code, following the first-listed code for the underlying disease.

  • When coding for the diagnosis of chronic alcoholic liver failure in a patient with long-standing alcohol use and dependence, the first-listed code will be K70.40, followed by the secondary code F10.288, Alcohol dependence with other alcohol-induced disorder.

Diseases of the Skin and Subcutaneous Tissue (Chapter 12)

Chapter 12 of ICD-10-CM is titled "Disease of the Skin and Subcutaneous Tissue," which includes categories L00-L99. The skin is the largest body organ, and is also called the integumentary system. The skin gives us a protective barrier against infections, maintains temperature control, and allows for regulation of metabolism.

  •  L00-L08 Infections of the Skin and Subcutaneous Tissue – Codes in this subsection correspond with those in categories 680-686 in ICD-9-CM Conditions coded include imptetigo, cellulitis, carbuncle, furuncle, cutaneous abscess, staphylococcal scalded skin syndrome, erythrasma, pyoderma, pyoderma vegetans, pilonidal cyst, and acute lymphangitis.

  • L10-L14 Bullous Disorders – Codes in this subsection correspond with those in category 694 in ICD-9-CM Conditions coded include acquired keratosis follicularis, pemphigus, acantholytic dermatosis, pemphigoid, dermatitis herpetiformis, and subcorneal pustular dermatitis.

  • L20-L30 Dermatitis and Eczema - Codes in this subsection correspond with those in categories 690-693 and 698 in ICD-9-CM Conditions coded include diaper dermatitis, allergic contact dermatitis, atopic dermatitis, seborrheic dermatitis, dyshidrosis, and other skin rash disorders.

  • L40-L45 Papulosquamous Disorders - Codes in this subsection correspond with those in categories 696-697 in ICD-9-CM Conditions coded include parapsoriasis, psoriasis, pityriasis rosea, lichen ruber moniliformis, lichen striatus, lichen nitidus, pityriasis rubra pilaris, and other papulosquamous disorders.

  • L49-L54 Urticaria and Erythema - Codes in this subsection correspond with those in categories 695 and 708 in ICD-9-CM Conditions coded include erythema multiforme, urticarial, erythema nodosum, toxic erythema, erythema annulare centrifugum, erythema marginatum, and other forms of erythema.

  •  L55-L59 Radiation-Related Disorders of the Skin and Subcutaneous Tissue - Codes in this subsection correspond with those in category 692 in ICD-9-CM Conditions coded include skin changes due to ultraviolet radiation, chronic exposure to nonionizing radiation, radiodermatitis, and erythema ab igne. 

  • L60-L75 Disorders of Skin Appendages - Codes in this subsection correspond with those in categories 680-686 in ICD-9-CM Conditions coded include alopecia areata, rosacea, androgenic alopecia, acne, perioral dermatitis, rhinophyma, pseudofolliculitis barbae, hidradenitis suppurativa, eccrine sweat disorders, and apocrine sweat disorders. 

  • L76 Intraoperative and Postprocedural Complications of Skin and Subcutaneous Tissue - Codes in this subsection correspond with those in categories 680-686 in ICD-9-CM Conditions coded include accidental puncture and laceration, hematoma, hemorrhage during surgery, postsurgical hemorrhage, and other complications that occur in or after surgery. 

  • L80-L99 Other Disorders of the Skin and Subcutaneous Tissue - Codes in this subsection correspond with those in categories 680-686 in ICD-9-CM Conditions coded include corns, callosities, epidermal thickening, acanthosis nigricans, seborrheic keratosis, hyperpigmentation, vitiligo, pyoderma gangrenosium, pressure ulcers, atrophic skin disorders, various hypertrophic disorders, and scarring of the skin. 

General Guidelines

  • When assigning codes in category L00-L08, Infections of the Skin and Subcutaneous Tissue, a secondary code from the B95-B97 range is needed to report the infectious agent.

  • Codes in category L32 allow the coder to report the specific causative agent, such as metals, adhesives, topical medications, cosmetics, and dyes.

  • Codes in category L24 allow the coder to provide the specific irritant, such as oils, greases, solvents, detergents, cosmetics, chemicals, and foods.

  • When coding for dermatitis caused by a particular substance taken internally, the coder should first assign a code from range T36-T65 to report the substance, followed by a code from category L27.

  • Coding the conditions in category L51 requires the coder to assign a secondary code from category L49 to report the percentage of skin exfoliation.

  • For coding skin change changes from exposure to radiation, the source of ultraviolet radiation should be reported with an additional code should be used from categories L56, L57, and L58.

 
 
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