ICD 10 Coding Alert

Question: A patient previously diagnosed with Barrett’s esophagus (without dysplastic changes) came to our gastroenterologist’s office for a surveillance visit. The gastroenterologist evaluated the patient’s symptoms and proceeded to perform an endoscopy with biopsy of the esophagus. The biopsied specimen was sent to the laboratory to check for dysplasia. The laboratory results confirmed the presence of low-grade dysplastic changes. How should I report this?

Texas Subscriber

Answer: You’ll report this condition with K22.7 (Barrett’s Esophagus). However, you need to look deeper into the patient notes prior to reporting the diagnosis of Barrett’s esophagus. This is because ICD-10 codes are specific in reporting Barrett’s esophagus based on the presence or absence of dysplastic changes. So K22.7 expands into a fourth digit classification based on these factors:

• K22.70 -- Barrett’s esophagus without dysplasia
• K22.71 -- … with dysplasia

In addition, K22.71 expands out to a further fifth digit classification based on the grade of dysplastic changes. So if dysplasia is present, you will have to further look through the documentation to see if there is any mention about the degree of dysplasia that is present to correctly report the diagnosis of Barrett’s esophagus.

• K22.710 -- … with low grade dysplasia
• K22.711 -- … with high grade dysplasia
• K22.719 -- … with dysplasia, unspecified

Therefore, in this situation, the appropriate code is K22.710.