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ICD-10 Guide
ICD-10 CodesK31.89

K31.89

Billable

Other diseases of stomach and duodenum

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

Code Description

ICD-10 K31.89 is a billable code used to indicate a diagnosis of other diseases of stomach and duodenum.

Key Diagnostic Point:

K31.89 is used to classify other diseases of the stomach and duodenum that do not fall under more specific categories. This includes a variety of gastrointestinal conditions such as gastritis, peptic ulcers, and functional dyspepsia that may not be clearly defined. Clinically, patients may present with symptoms such as abdominal pain, nausea, vomiting, and changes in appetite. The stomach and duodenum are integral parts of the digestive system, playing crucial roles in food digestion and nutrient absorption. Disease progression can vary; some conditions may be acute and self-limiting, while others can lead to chronic issues requiring ongoing management. Diagnostic considerations include endoscopy, imaging studies, and laboratory tests to rule out malignancies or other serious conditions. Accurate diagnosis is essential for appropriate treatment and management of symptoms, which may include medications, dietary changes, or surgical interventions depending on the underlying cause.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Conditions under K31.89 can vary widely in etiology and presentation, requiring thorough evaluation.
  • Treatment complexity: Management may range from lifestyle modifications to pharmacotherapy or surgical options.
  • Documentation requirements: Comprehensive documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: While K31.89 is a catch-all code, it lacks the specificity of more defined codes, which can complicate coding.

Audit Risk Factors

  • Common coding errors: Misuse of K31.89 when a more specific code is applicable.
  • Documentation gaps: Insufficient clinical details to support the diagnosis.
  • Billing challenges: Potential for claim denials if documentation does not clearly justify the use of this code.

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

Internal Medicine

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

The clinical significance of K31.89 lies in its ability to capture a variety of gastrointestinal disorders that may affect a significant portion of the population. These conditions can lead to increased healthcare utilization, including outpatient visits, diagnostic testing, and potential hospitalizations. Understanding the epidemiology of these diseases can help healthcare providers implement preventive measures and improve patient outcomes. Quality measures related to gastrointestinal health can also be enhanced through accurate coding and documentation.

ICD-9 vs ICD-10

The clinical significance of K31.89 lies in its ability to capture a variety of gastrointestinal disorders that may affect a significant portion of the population. These conditions can lead to increased healthcare utilization, including outpatient visits, diagnostic testing, and potential hospitalizations. Understanding the epidemiology of these diseases can help healthcare providers implement preventive measures and improve patient outcomes. Quality measures related to gastrointestinal health can also be enhanced through accurate coding and documentation.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the diagnosis aligns with the services billed. Common denials may arise from insufficient documentation or the use of K31.89 when a more specific code is available. Best practices include regular training for coding staff on the nuances of gastrointestinal coding and maintaining clear communication between providers and coders.

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 K31.89?

K31.89 encompasses a range of conditions affecting the stomach and duodenum that are not classified elsewhere, including atypical gastritis, functional dyspepsia, and other unspecified gastrointestinal disorders.

When should K31.89 be used instead of related codes?

K31.89 should be used when a patient's condition does not fit into more specific categories, and when there is a need to document a non-specific disease of the stomach or duodenum that requires treatment or monitoring.

What documentation supports K31.89?

Documentation should include a detailed clinical history, symptom description, diagnostic test results, and any treatment plans. Clear justification for the use of this code is essential to avoid denials.