In this edition we will take a look at Cholelithiasis diagnoses and illustrate the increased specificity under the ICD-10-CM nomenclature.
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1 On October 1, 2015, the ICD-9-CM code set that is used to report medical diagnoses in the United States will be replaced with the ICD-10-CM code set. The new code set provides more than 68,000 codes, compared to 13,000 in ICD-9, and introduces alphanumeric category classifications for the first time. As such, ICD-10 is much more proficient at describing current conditions and healthcare practices, and possesses the flexibility to expand as needed to accommodate the changing environment. This newsletter is part of a series by APS Medical Billing that illustrates the changes that will occur in transitioning to the new code set for sample conditions, providing the additional documentation that should be included in the radiologist s report to direct proper diagnosis code assignment, come October 1, In this edition we will take a look at Cholelithiasis diagnoses and illustrate the increased specificity under the ICD-10-CM nomenclature. Cholelithiasis In ICD-9-CM there are 20 codes available, while ICD-10-CM doubles the code choices, requiring dictation to specify: Location, additional condition, nature of additional condition, presence of Gallbladder With acute With other Other Without Page 1 of 5 Issue 3 June 2014
2 Bile duct With cholangitis With Without cholangitis or Gallbladder and bile duct With Without Other ICD-9-CM Code(s) CALCULUS OF GALLBLADDER Calculus of gallbladder with acute Biliary calculus with acute Calculus of cystic duct with acute Cholelithiasis with acute Any condition classifiable to with acute ICD-10-CM Code(s) CALCULUS OF GALLBLADDER K80.0 Calculus of gallbladder with acute add 5 th digit: K80.00 Calculus of gallbladder with acute without K80.01 Calculus of gallbladder with acute with any condition listed in K80.2 with acute Page 2 of 5 Issue 3 June 2014
3 574.1 Calculus of gallbladder with other Biliary calculus with Calculus of cystic duct with Cholelithiasis with Cholecystitis with cholelithiasis NOS Any condition classifiable to with (chronic) Calculus of gallbladder without mention of Biliary calculus NOS Biliary colic NOS Calculus of cystic duct Cholelithiasis NOS Colic (recurrent) of gallbladder Gallstone (impacted) specify status: 0 without mention of 1 with CALCULUS OF BILE DUCT Calculus of bile duct with acute Calculus of bile duct (any) with acute Choledocholithiasis with acute Any condition classifiable to with acute Calculus of bile duct with other Calculus of bile duct (any) with (chronic) Choledocholithiasis with (chronic) K80.1 Calculus of gallbladder with other add 5 th digit: K80.10 Calculus of gallbladder with chronic without (includes Cholelithiasis with NOS) K80.11 Calculus of gallbladder with chronic with K80.12 Calculus of gallbladder with acute and chronic without K80.13 Calculus of gallbladder with acute and chronic with K80.18 Calculus of gallbladder with other without K80.19 Calculus of gallbladder with other with K80.2 Calculus of gallbladder without add 5 th digit K80.20 Calculus of gallbladder without without K80.21 Calculus of gallbladder without with Code set includes: Cholecystolithiasis without Cholelithiasis (without ) Colic (recurrent) of gallbladder (without ) Gallstone (impacted)of cystic duct (without ) Gallstone (impacted) of gallbladder (without ) CALCULUS OF BILE DUCT K80.3 Calculus of bile duct with cholangitisadd 5 th digit: K80.30 Calculus of bile duct with cholangitis, unspecified, without K80.31 Calculus of bile duct with cholangitis, unspecified, with K80.32 Calculus of bile duct with acute cholangitis without K80.33 Calculus of bile duct with acute cholangitis with Page 3 of 5 Issue 3 June 2014
4 Any condition classifiable to with (chronic) Calculus of bile duct without mention of Calculus of: o bile duct (any) o common duct o hepatic duct Choledocholithiasis Hepatic: o colic (recurrent) o lithiasis specify status: 0 without mention of 1 with K80.34 Calculus of bile duct with chronic cholangitis without K80.35 Calculus of bile duct with chronic cholangitis with K80.36 Calculus of bile duct with acute and chronic cholangitis without K80.37 Calculus of bile duct with acute and chronic cholangitis with any condition listed in K80.5 with cholangitis K80.4 Calculus of bile duct with add 5 th digit K80.40 Calculus of bile duct with, unspecified, without K80.41 Calculus of bile duct with, unspecified, with K80.42 Calculus of bile duct with acute without K80.43 Calculus of bile duct with acute with K80.44 Calculus of bile duct with chronic without K80.45 Calculus of bile duct with chronic with K80.46 Calculus of bile duct with acute and chronic without K80.47 Calculus of bile duct with acute and chronic with any condition listed in K80.5 with (with cholangitis) K80.5 Calculus of bile duct without cholangitis or add 5 th digit: K80.50 Calculus of bile duct without cholangitis or without K80.51 Calculus of bile duct without cholangitis or with Code set includes: Choledocholithiasis (without cholangitis or ) Gallstone (impacted) of bile duct NOS (without cholangitis or ) Gallstone (impacted) of common duct (without cholangitis or ) Gallstone (impacted) of hepatic duct (without cholangitis or ) Page 4 of 5 Issue 3 June 2014
5 CALCULUS OF GALLBLADDER AND BILE DUCT Calculus of gallbladder and bile duct with acute any condition classifiable to and Calculus of gallbladder and bile duct with other any condition classifiable to and Calculus of gallbladder and bile duct with acute and chronic any condition classifiable to and Calculus of gallbladder and bile duct without Any condition classifiable to and specify status: 0 without mention of 1 with Hepatic cholelithiasis (without cholangitis or ) Hepatic colic (recurrent) (without cholangitis or ) CALCULUS OF GALLBLADDER AND BILE DUCT K80.6 Calculus of gallbladder and bile duct with add 5 th digit: K80.60 Calculus of gallbladder and bile duct with, unspecified, without K80.61 Calculus of gallbladder and bile duct with, unspecified, with K80.62 Calculus of gallbladder and bile duct with acute without K80.63 Calculus of gallbladder and bile duct with acute with K80.64 Calculus of gallbladder and bile duct with chronic without K80.65 Calculus of gallbladder and bile duct with chronic with K80.66 Calculus of gallbladder and bile duct with acute and chronic without K80.67 Calculus of gallbladder and bile duct with acute and chronic with K80.7 Calculus of gallbladder and bile duct without add 5 th digit K80.70 Calculus of gallbladder and bile duct without without K80.71 Calculus of gallbladder and bile duct without with OTHER CHOLELITHIASIS K80.8 Other Cholelithiasis add 5 th digit: K80.80 Other cholelithiasis without K80.81 Other cholelithiasis with Page 5 of 5 Issue 3 June 2014
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