General Surgery Coding Alert

Blood in the stool can lead to many different diagnoses, but if your surgeon has positively identified angiodysplasia lesions in the intestine, you currently have just two choices.

 

When ICD-10 goes into effect, you’ll still have two code choices, which are virtually a direct crosswalk from the ICD-9 codes. Read “ICD-10 update: See How CMS Addresses Delay” on page 52 to get an update on the expected implementation date for ICD-10.  

 

Pick from 2 ICD-9 Choices 

 

Depending on presence or absence of hemorrhage, you will report intestinal angiodysplasia using one of the following two ICD-9 codes:

Caveat: If your surgeon diagnoses angiodysplasia of the stomach or the duodenum, you cannot use these two codes. Instead, depending on the presence or absence of hemorrhage, you would report the diagnosis with 537.82 (Angiodysplasia of stomach and duodenum [without hemorrhage]) or 537.83 (Angiodysplasia of stomach and duodenum with hemorrhage) if the location of the vascular deformity is in the stomach or duodenum.

 

Note: Although a dieulafoy lesion of the intestine is a hemorrhagic lesion, you should not report those findings using 569.85. You have a separate code to report this condition: 569.86 (Dieulafoy lesion [hemorrhagic] of intestine). 

 

Observe Minor ICD-10 Descriptor Change

 

When you begin using ICD-10 codes, a diagnosis of angiodysplasia of the intestine will again rely on the presence or absence of hemorrhage, as follows:

You cannot report angiodysplasia of the stomach and duodenum with K55.20 or K55.21. Instead, as in ICD-9, you’ll need to take note of the hemorrhage and report angiodysplasia of the stomach or duodenum using different codes. For ICD-10, select either K31.811 (Angiodysplasia of stomach and duodenum with bleeding) or K31.819 (Angiodysplasia of stomach and duodenum without bleeding).

 

Dieulafoy lesion: As with ICD-9, You’ll have a separate code for this condition in ICD-10: K63.81 (Dieulafoy lesion of intestine. Note that K63.81 does not include the “hemorrhagic” descriptor in ICD-10-CM, says Kelly C. Loya, CPC-I, CHC, CPhT, CRMA, director of reimbursement and advisory services with Altegra Health, Inc. in Los Angeles.