Gastroenterology Coding Alert

You’ll now be able to specify when patients experience bleeding and when they don’t.

GI coders will be able to avoid using unspecified codes for esophagitis and reflux starting this October, thanks to a few new diagnosis code additions that will impact gastroenterology practices. In addition, your coding for Ogilvie syndrome will no longer be relegated to using nonspecific codes, thanks to a code that describes the syndrome on its own.

Background: On July 1, CMS released the new ICD-10-CM codes and descriptors, with a total of 490 additions, 58 code deletions, and 47 revisions that will go into effect on October 1. Although there aren’t dozens of codes impacting GI practices this year, the ones that are debuting will allow you to get much more specific on your claims.

Bleeding Now Specified for These Conditions

Some of the changes to the 2021 code set are the result of stakeholder requests made at last year’s ICD-10-CM Coordination and Maintenance Committee (ICMC) Meeting, during which the ICMC’s Shannon McConnell-Lamptey offered some insight into the following new code additions:

• K20.80 (Other esophagitis without bleeding)
• K20.81 (… with bleeding)
• K21.00 (Gastro-esophageal reflux disease with esophagitis, without bleeding).
• K21.01 (…with bleeding)

The new codes rectify the problem of ICD-10 not including combination codes that reflect bleeding with these conditions. “In ICD-9-CM, there was a unique code for esophageal hemorrhage,” she said when requesting these new code additions. “This proposal has been reviewed and supported by the American Gastroenterological Association (AGA).”

Ogilvie Syndrome Code Debuts

In addition to the bleeding specification codes, gastroenterology practices will also benefit from two new options under K59.8 (Other specified functional intestinal disorders):

• K59.81 (Ogilvie syndrome)
• K59.89 (Other specified functional intestinal disorders)

“Ogilvie syndrome is a rare, acquired disorder characterized by abnormalities affecting the involuntary, rhythmic muscular contractions within the colon,” McConnell-Lamptey said when initially proposing the new codes.

Also referred to as “acute colonic pseudo-obstruction,” symptoms of Ogilvie syndrome may include vomiting, nausea, abdominal colic, and constipation, and can mimic the symptoms of mechanical blockage of the colon, but physicians then find that no such physical obstruction is present. “It is not the same as chronic intestinal pseudoobstruction (CIP), a similar, but distinct disorder,” she said. “A facility-based Health Information Management (HIM) professional is requesting the following new codes to accurately identify this condition. This proposal has been reviewed and supported by the AGA.”

You can start using these new codes on October 1, 2020, but it’s a good idea to get to know them now, and to adjust any EHR programs or superbills to reflect the upcoming new code debuts.