Gastroenterology Coding Alert

Answer: Celiac disease and gluten sensitivity are different conditions and should be coded differently. Only diagnosed celiac disease should be reported with K90.0 (Celiac disease). Sensitivity should be coded with K90.41 (Non-celiac gluten sensitivity).

The cause of the confusion, however, is not difficult to understand. Both gluten sensitivity and celiac disease cause the body to negatively respond to gluten protein, which is found in food made using grains such as wheat, barley, and rye. Gluten sensitivity causes minor, short-term symptoms such as stomach pain and bloating. However, celiac disease causes long-term health problems such as nutrient malabsorption and bowel damage in addition to the inconvenient stomach aches and bloating.

This is why you should be careful when selecting between K90.0 and K90.41. Pay close attention to the documentation and query the provider if you can’t find definitive diagnosis for either condition.

Note: The K90.4- (Other malabsorption due to intolerance) codes have an Excludes2 instruction that allows you to code both celiac and non-celiac gluten sensitive enteropathy and lactose intolerance (K90.0, K90.41, and E73.-) together when your gastroenterologist documents them.