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ICD-10 Guide
ICD-10 CodesK80.00

K80.00

Billable

Calculus of gallbladder with acute cholecystitis without obstruction

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K80.00 is a billable code used to indicate a diagnosis of calculus of gallbladder with acute cholecystitis without obstruction.

Key Diagnostic Point:

K80.00 refers to the presence of gallstones (calculi) in the gallbladder accompanied by acute cholecystitis without obstruction. The gallbladder is a small organ located beneath the liver, responsible for storing bile, which aids in digestion. Acute cholecystitis occurs when the gallbladder becomes inflamed, often due to the obstruction of the cystic duct by gallstones. Patients typically present with severe abdominal pain in the right upper quadrant, nausea, vomiting, and fever. The condition may progress rapidly, leading to complications such as perforation or abscess formation if not treated promptly. Diagnosis is primarily through imaging studies, such as ultrasound or CT scans, which can visualize gallstones and assess gallbladder inflammation. Laboratory tests may reveal elevated white blood cell counts and liver function abnormalities. Treatment usually involves surgical intervention, often laparoscopic cholecystectomy, to remove the gallbladder and resolve the acute inflammation. Early diagnosis and management are crucial to prevent serious complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm diagnosis.
  • Treatment complexity: Surgical intervention may be necessary, with potential for complications.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise coding to differentiate from other gallbladder conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of acute cholecystitis with or without obstruction.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and imaging findings.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: General Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K80.00 lies in its potential to lead to serious complications if not treated promptly. Population health impact includes the prevalence of gallbladder diseases, which can affect a significant portion of the population, particularly those with risk factors such as obesity and high-fat diets. Quality measures related to timely intervention and surgical outcomes are critical for healthcare providers, influencing healthcare utilization patterns and resource allocation.

ICD-9 vs ICD-10

The clinical significance of K80.00 lies in its potential to lead to serious complications if not treated promptly. Population health impact includes the prevalence of gallbladder diseases, which can affect a significant portion of the population, particularly those with risk factors such as obesity and high-fat diets. Quality measures related to timely intervention and surgical outcomes are critical for healthcare providers, influencing healthcare utilization patterns and resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that all relevant imaging and laboratory results are included in the medical record. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for surgical intervention. Coders should ensure that the coding aligns with the clinical documentation to avoid discrepancies during audits.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K80.00?

K80.00 specifically covers cases of gallstones in the gallbladder leading to acute cholecystitis without any obstruction of the cystic duct. This includes patients presenting with symptoms indicative of gallbladder inflammation but without complications such as perforation or abscess.

When should K80.00 be used instead of related codes?

K80.00 should be used when there is clear evidence of acute cholecystitis due to gallstones without obstruction. If there is obstruction present, K80.01 should be selected. Accurate imaging and clinical findings are crucial for differentiation.

What documentation supports K80.00?

Documentation should include clinical notes detailing the patient's symptoms, results of imaging studies confirming gallstones and inflammation, laboratory test results, and any treatment plans discussed or implemented.