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ICD-10 Guide
ICD-10 CodesK31.3

K31.3

Billable

Pylorospasm, not elsewhere classified

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

Code Description

ICD-10 K31.3 is a billable code used to indicate a diagnosis of pylorospasm, not elsewhere classified.

Key Diagnostic Point:

Pylorospasm, not elsewhere classified, refers to a condition characterized by the involuntary contraction of the pyloric sphincter, which is located at the junction of the stomach and the duodenum. This condition can lead to gastric outlet obstruction, resulting in symptoms such as abdominal pain, nausea, vomiting, and postprandial fullness. The pylorus plays a crucial role in regulating the passage of food from the stomach into the small intestine, and dysfunction in this area can significantly impact digestion. The etiology of pylorospasm may include neurological factors, stress, or underlying gastrointestinal disorders. Diagnosis typically involves clinical evaluation, patient history, and may include imaging studies or endoscopy to rule out other conditions. Treatment options can vary from dietary modifications to pharmacological interventions aimed at reducing sphincter tone or, in severe cases, surgical intervention. Understanding the progression of pylorospasm is essential for effective management and prevention of complications such as dehydration or malnutrition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis to exclude other gastrointestinal disorders.
  • Treatment complexity: Management may involve multiple specialties and treatment modalities.
  • Documentation requirements: Detailed clinical documentation is necessary to support diagnosis and treatment.
  • Coding specificity: Limited specificity may lead to challenges in accurately capturing the condition.

Audit Risk Factors

  • Common coding errors: Misclassification with other pyloric disorders.
  • Documentation gaps: Insufficient clinical details to support the diagnosis.
  • Billing challenges: Potential for denials if documentation does not clearly justify the use of K31.3.

Specialty Focus

Medical Specialties

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

Pediatrics

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

Pylorospasm can significantly affect patient quality of life, leading to decreased nutritional intake and increased healthcare utilization due to recurrent symptoms. Understanding the epidemiology of pylorospasm is crucial, as it can occur in both pediatric and adult populations, often leading to unnecessary interventions if not accurately diagnosed. Quality measures related to gastrointestinal health may include monitoring the incidence of pylorospasm and ensuring appropriate management strategies are in place to reduce complications.

ICD-9 vs ICD-10

Pylorospasm can significantly affect patient quality of life, leading to decreased nutritional intake and increased healthcare utilization due to recurrent symptoms. Understanding the epidemiology of pylorospasm is crucial, as it can occur in both pediatric and adult populations, often leading to unnecessary interventions if not accurately diagnosed. Quality measures related to gastrointestinal health may include monitoring the incidence of pylorospasm and ensuring appropriate management strategies are in place to reduce complications.

Reimbursement & Billing Impact

reimbursement. Regular audits of coding practices can help identify and rectify common billing issues.

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 K31.3?

K31.3 specifically covers pylorospasm that is not classified elsewhere, which may include idiopathic pylorospasm or cases secondary to other gastrointestinal disorders. It does not include pyloric stenosis or other obstructive conditions.

When should K31.3 be used instead of related codes?

K31.3 should be used when the primary diagnosis is pylorospasm without other specified conditions. It is important to differentiate it from K31.2 (Pyloric stenosis) based on clinical findings and diagnostic imaging.

What documentation supports K31.3?

Documentation should include a thorough patient history, clinical symptoms, diagnostic imaging results, and any treatment plans. Clear notes on the absence of other gastrointestinal conditions are also critical.