General Surgery Coding Alert

Question: I’m used to certain basic diagnoses that we face all the time, like intestinal obstruction, but I get confused because ICD-10 has so much detail. For instance, how should I code partial obstruction due to intestinal adhesions?

Codify Subscriber

Answer: The correct code for your example is K56.51 (Intestinal adhesions [bands], with partial obstruction).

You are correct that ICD-10-CM provides diagnosis codes to a high level of specificity. For coders who are used to using “basic” diagnosis codes, that can prove to be a challenge.

For intestinal obstruction, here’s a quick summary of diagnosis code choices, many of which require a 5th digit to indicate even more clinical detail:

• K56.0 (Paralytic ileus)
• K56.1 (Intussusception)
• K56.2 (Volvulus)
• K56.3 (Gallstone ileus)
• K56.4- (Other impaction of intestine)
• K56.5- (Intestinal adhesions [bands] with obstruction (postinfection))
• K56.6- (Other and unspecified intestinal obstruction)
• K56.7 (Ileus, unspecified).

That’s not all: In addition to the K56 code family for paralytic ileus and intestinal obstruction without hernia, you should be familiar with related codes that appear in several “excludes” notes, such as the following:

• K91.3- (Postprocedural intestinal obstruction)
• K38.8 (Intussusception of appendix)
• K40-K46 (Intestinal obstruction with hernia)
• K59.0- (Constipation).