ACDIS day1-18 track1-4 pres 0517-Siegel-f
嚜澧DI and the Digestive System: Avoid Documentation Dyspepsia
Drew Siegel, MD, MS, CCDS, CPC
Clinical Documentation Improvement Program
Barnes坼Jewish Hospital/MedPartners
St. Louis, MO
1
Learning Objectives
? At the completion of this educational activity, the
learner will be able to:
每 Recognize common GI diagnoses and their coding
requirements
每 Identify query opportunities that are supported by clinical
indicators
每 Recall newly created ICD坼10 codes and AHA Coding Clinics
related to GI diagnoses
2
Diseases of Digestive System
? K20每K31 Diseases of the esophagus, stomach, and
duodenum
? K40每K46 Hernias
? K50每K52 Non坼infectious enteritis and colitis
? K55每K64 Other disease of the intestine
? K65每K68 Diseases of the peritoneum and retroperitoneum
? K70每K77 Diseases of the liver
? K80每K87 Diseases of the gallbladder, biliary tree, and
pancreas
? K90每K95 Other diseases of the digestive system
? I85 Esophageal varices
3
2017 Copyright, HCPro, an H3.Group division of Simplify Compliance LLC. All rights reserved.
These materials may not be copied without written permission.
1
Gastroesophageal Reflux Disease (GERD)
? Gastroesophageal reflux disease
每 With esophagitis (K21.0)
每 Without esophagitis (K21.9)
? Erosive esophagitis, ulcerative esophagitis
每 Without bleeding (K22.10)
每 With bleeding (K22.11)
4
Other Diseases of the Esophagus
? Barrett＊s esophagus (K22.7XX)
? Eosinophilic esophagitis
(K20.0)
? Candida esophagitis (B37.81)
? Esophageal ulcer due to
medication (K22.1X and
T509.05A) or
poisoning/suicide attempts
? Strictures/stenosis (K22.2)
Eosinophilic esophagitis
Esophagitis with stricture
Eosinophilic Esophagitis
Erosive esophagitis with stricture
5
Ulcers of the Esophagus
? Query opportunities
每 Bleeding
? Establish causal relationship with endoscopic finding
每 Acute blood loss anemia
每 Nutritional diagnosis
6
2017 Copyright, HCPro, an H3.Group division of Simplify Compliance LLC. All rights reserved.
These materials may not be copied without written permission.
2
Mallory坼Weiss Tear (K22.6)
? Gastroesophageal laceration〞hemorrhagic syndrome
7
Esophageal Perforation (non坼traumatic)
(K22.3)
? Boerhaave＊s syndrome
每 ※The patient ate a meal that included veal
soup, cabbage boiled with mutton, calf
sweetbreads, spinach, duck, two larks, apple
compote, bread, and beer§
每 Several hours later patient vomited forcefully,
ruptured his esophagus, and died in agony
days later
By J. Chapman,
8
Esophageal Varices (I85.XX)
? Types:
每 Primary/idiopathic
? Uncommon
? Not bleeding (I85.00)
? With bleeding (I85.01)
每 Secondary
? Most common type
每 Cirrhosis of the liver
每 Alcoholic liver disease
每 Schistosomiasis (rare in U.S.)
? Code the underlying cause first (principal
diagnosis)
9
2017 Copyright, HCPro, an H3.Group division of Simplify Compliance LLC. All rights reserved.
These materials may not be copied without written permission.
3
Secondary Esophageal Varices
? Without bleeding (I85.10)
Fig. 1
? With bleeding (I85.11)
Fig. 2
Fig. 1: 坼_wale.jpg
Fig. 2:
10
Esophageal Varices
? Query opportunities
每
每
每
每
Underlying cause (code first)
Link the diagnosis with the bleeding
Hypovolemic shock
ABLA
11
Gastric and Duodenal Ulcers
? Gastric ulcers (K25.X)
每 Includes gastric erosions, stomach and pyloric ulcers
? Duodenal ulcers (K26.X)
每 Includes duodenal erosions, postpyloric ulcer
? Gastrojejunal ulcers (K28.X)
每 Marginal, anastomotic
12
2017 Copyright, HCPro, an H3.Group division of Simplify Compliance LLC. All rights reserved.
These materials may not be copied without written permission.
4
Gastric and Duodenal Ulcers
?
?
?
?
Acute, chronic (default)
Hemorrhage
Perforation
Both hemorrhage and perforation
Examples:
? Gastric ulcer with hemorrhage (K25.4)
? Acute duodenal ulcer with perforation (K26.1)
13
Bleeding Gastric Ulcer
14
Gastrointestinal Hemorrhage
Patient is admitted with hematemesis.
Upper endoscopy report:
每 Duodenal ulcer, no active bleeding present. A clip was
placed on a visible vessel.
#/media/File:DU_2.jpg
media/File:GU_with_clip.jpg
15
2017 Copyright, HCPro, an H3.Group division of Simplify Compliance LLC. All rights reserved.
These materials may not be copied without written permission.
5
................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.