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ICD-10 Guide
ICD-10 CodesK11.23

K11.23

Billable

Chronic sialoadenitis

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

Code Description

ICD-10 K11.23 is a billable code used to indicate a diagnosis of chronic sialoadenitis.

Key Diagnostic Point:

Chronic sialoadenitis is a long-term inflammation of the salivary glands, primarily affecting the parotid, submandibular, and sublingual glands. Clinically, patients may present with recurrent swelling, pain, and tenderness in the affected gland, particularly during meals when saliva production is stimulated. The condition can arise from various etiologies, including ductal obstruction due to stones (sialolithiasis), autoimmune disorders, or chronic infections. Anatomically, the salivary glands are located in the oral cavity and neck, and their dysfunction can significantly impact oral health and digestion. Disease progression may lead to complications such as abscess formation or gland atrophy if left untreated. Diagnostic considerations include imaging studies like ultrasound or sialography to assess ductal patency and identify any obstructive lesions. A thorough clinical history and physical examination are essential for accurate diagnosis and management planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation.
  • Treatment complexity: May involve surgical intervention or management of underlying causes.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires precise coding to differentiate from acute sialoadenitis and other salivary gland disorders.

Audit Risk Factors

  • Common coding errors: Misclassification with acute conditions.
  • Documentation gaps: Incomplete clinical notes regarding symptom duration and treatment.
  • Billing challenges: Potential denials if documentation does not support chronicity.

Specialty Focus

Medical Specialties

Otolaryngology

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

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

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Chronic sialoadenitis can significantly affect patients' quality of life, leading to difficulties in eating and increased risk of infections. It is important in population health as it may indicate underlying systemic conditions, such as autoimmune diseases. Understanding the epidemiology of this condition can help healthcare providers identify at-risk populations and implement preventive measures, ultimately improving healthcare utilization and patient outcomes.

ICD-9 vs ICD-10

Chronic sialoadenitis can significantly affect patients' quality of life, leading to difficulties in eating and increased risk of infections. It is important in population health as it may indicate underlying systemic conditions, such as autoimmune diseases. Understanding the epidemiology of this condition can help healthcare providers identify at-risk populations and implement preventive measures, ultimately improving healthcare utilization and patient outcomes.

Reimbursement & Billing Impact

Reimbursement may depend on the thoroughness of clinical notes that demonstrate the necessity of diagnostic imaging and any procedures performed. Common denials may occur if the documentation does not clearly establish the chronicity or if the treatment plan is not well-articulated. Best practices include ensuring that all clinical encounters are documented with specific details regarding symptoms, treatment responses, and follow-up plans.

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 K11.23?

K11.23 specifically covers chronic sialoadenitis, which may be associated with conditions such as recurrent sialolithiasis, Sjögren's syndrome, or chronic bacterial infections. It is important to differentiate this from acute sialoadenitis, which is characterized by sudden onset and may require different management.

When should K11.23 be used instead of related codes?

K11.23 should be used when the clinical presentation indicates a chronic condition lasting longer than three months, with recurrent symptoms. If the condition is acute or has a different underlying cause, other codes such as K11.21 should be considered.

What documentation supports K11.23?

Documentation should include a detailed history of symptoms, physical examination findings, imaging results, and any treatments attempted. Evidence of chronicity, such as recurrent episodes over time, should be clearly noted to support the use of K11.23.