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Coding Grades of Esophagitis Question
When a Diagnosis is listed as Grade “x” Esophagitis with no additional detail, what DX code(s) would you assign for each of the below grades?
-If there’s not one base code for each, would you code a base NOS or Other (K20.80/K20.90) and add erosion, ulcer, Barrett’s, etc.?
The Savary-Miller grading system commonly used:
Grade 1: single or multiple erosions on a single fold. Erosions may be exudative or erythematous.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential erosions.
Grade 4: ulcer, stenosis, or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia in the form of circular or non-circular (islands or tongues) extensions.
The more recent and more objective Los Angeles grades A to D classification is also used:
Grade A: one or more mucosal breaks no longer than 5 mm, none of which extends between the tops of the mucosal folds.
Grade B: one or more mucosal breaks more than 5 mm long, none of which extends between the tops of two mucosal folds.
Grade C: mucosal breaks that extend between the tops of two or more mucosal folds, but which involve <75% of the mucosal circumference.
Grade D: mucosal breaks which involve ≥75% of the mucosal circumference.
When a Diagnosis is listed as Grade “x” Esophagitis with no additional detail, what DX code(s) would you assign for each of the below grades?
-If there’s not one base code for each, would you code a base NOS or Other (K20.80/K20.90) and add erosion, ulcer, Barrett’s, etc.?
The Savary-Miller grading system commonly used:
Grade 1: single or multiple erosions on a single fold. Erosions may be exudative or erythematous.
Grade 2: multiple erosions affecting multiple folds. Erosions may be confluent.
Grade 3: multiple circumferential erosions.
Grade 4: ulcer, stenosis, or esophageal shortening.
Grade 5: Barrett's epithelium. Columnar metaplasia in the form of circular or non-circular (islands or tongues) extensions.
The more recent and more objective Los Angeles grades A to D classification is also used:
Grade A: one or more mucosal breaks no longer than 5 mm, none of which extends between the tops of the mucosal folds.
Grade B: one or more mucosal breaks more than 5 mm long, none of which extends between the tops of two mucosal folds.
Grade C: mucosal breaks that extend between the tops of two or more mucosal folds, but which involve <75% of the mucosal circumference.
Grade D: mucosal breaks which involve ≥75% of the mucosal circumference.