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ICD-10 Guide
ICD-10 CodesA18.3

A18.3

Tuberculosis of intestines, peritoneum and mesenteric glands

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 A18.3 is a used to indicate a diagnosis of tuberculosis of intestines, peritoneum and mesenteric glands.

Key Diagnostic Point:

Tuberculosis of the intestines, peritoneum, and mesenteric glands is a form of extrapulmonary tuberculosis that primarily affects the gastrointestinal tract. It is caused by Mycobacterium tuberculosis and can manifest as abdominal pain, diarrhea, weight loss, and fever. The disease can lead to complications such as intestinal obstruction or perforation. Diagnosis typically involves imaging studies like CT scans or ultrasounds, endoscopic evaluations, and microbiological tests such as stool cultures or biopsies. Treatment usually includes a multi-drug regimen over an extended period, often involving isoniazid, rifampicin, ethambutol, and pyrazinamide. Monitoring for drug resistance is crucial, as resistance can complicate treatment and prolong recovery. Public health implications are significant, as tuberculosis is a communicable disease, necessitating contact tracing and isolation procedures for active cases to prevent transmission.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between intestinal tuberculosis and other gastrointestinal diseases.
  • Need for comprehensive documentation of symptoms and diagnostic tests.
  • Potential for co-infection with HIV, complicating the clinical picture.
  • Variability in presentation and severity of the disease.

Audit Risk Factors

  • Inadequate documentation of diagnostic tests.
  • Failure to document the presence of symptoms.
  • Misclassification of the disease as pulmonary tuberculosis.
  • Lack of follow-up documentation on treatment response.

Specialty Focus

Medical Specialties

Infectious Disease

Documentation Requirements

Detailed patient history, diagnostic test results, treatment plans, and follow-up notes.

Common Clinical Scenarios

Patients presenting with abdominal symptoms and a history of tuberculosis exposure.

Billing Considerations

Consideration of drug resistance and the need for specialized treatment regimens.

Gastroenterology

Documentation Requirements

Endoscopic findings, biopsy results, and imaging studies.

Common Clinical Scenarios

Patients with gastrointestinal symptoms and confirmed or suspected tuberculosis.

Billing Considerations

Differentiating between tuberculosis and other gastrointestinal disorders.

Coding Guidelines

Inclusion Criteria

Use A18.3 When
  • According to ICD
  • 10 guidelines, A18
  • 3 should be used when tuberculosis is confirmed in the intestines, peritoneum, or mesenteric glands

Exclusion Criteria

Do NOT use A18.3 When
  • Exclusion criteria include cases where tuberculosis is primarily pulmonary or where the gastrointestinal involvement is secondary to another condition

Related CPT Codes

45380CPT Code

Colonoscopy, flexible, diagnostic

Clinical Scenario

Used when evaluating gastrointestinal symptoms in suspected tuberculosis cases.

Documentation Requirements

Document findings, biopsies taken, and any interventions performed.

Specialty Considerations

Gastroenterologists should ensure thorough documentation of the procedure and findings.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of tuberculosis cases, improving the accuracy of data collection and treatment tracking. A18.3 provides a clear distinction for intestinal tuberculosis, which was less defined in ICD-9.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of tuberculosis cases, improving the accuracy of data collection and treatment tracking. A18.3 provides a clear distinction for intestinal tuberculosis, which was less defined in ICD-9.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of tuberculosis cases, improving the accuracy of data collection and treatment tracking. A18.3 provides a clear distinction for intestinal tuberculosis, which was less defined in ICD-9.

Resources

Clinical References

  • •
    CDC Tuberculosis (TB) Fact Sheet

Coding & Billing References

  • •
    CDC Tuberculosis (TB) Fact Sheet

Frequently Asked Questions

What are the common symptoms of intestinal tuberculosis?

Common symptoms include abdominal pain, diarrhea, weight loss, fever, and sometimes intestinal obstruction.

How is intestinal tuberculosis diagnosed?

Diagnosis typically involves imaging studies, endoscopic evaluations, and microbiological tests such as stool cultures or biopsies.

What is the treatment for intestinal tuberculosis?

Treatment usually involves a multi-drug regimen over an extended period, often including isoniazid, rifampicin, ethambutol, and pyrazinamide.

What are the public health implications of intestinal tuberculosis?

As a communicable disease, it necessitates contact tracing and isolation procedures for active cases to prevent transmission.