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ICD-10 Guide
ICD-10 CodesK52.22

K52.22

Billable

Food protein-induced enteropathy

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

Code Description

ICD-10 K52.22 is a billable code used to indicate a diagnosis of food protein-induced enteropathy.

Key Diagnostic Point:

Food protein-induced enteropathy (FPIE) is a gastrointestinal disorder primarily affecting infants and young children, characterized by an abnormal immune response to dietary proteins, particularly those found in cow's milk and soy. Clinically, patients may present with symptoms such as diarrhea, vomiting, abdominal pain, and failure to thrive. The condition is associated with inflammation of the intestinal mucosa, leading to malabsorption and nutritional deficiencies. The small intestine is primarily involved, where the immune response can damage the enterocytes, resulting in a compromised barrier function. Disease progression can vary, with some children outgrowing the condition by age 3, while others may experience persistent symptoms. Diagnosis typically involves a combination of clinical history, dietary elimination trials, and sometimes endoscopic evaluation with biopsy to assess for mucosal changes. It is crucial to differentiate FPIE from other gastrointestinal disorders such as celiac disease or food allergies, which may have overlapping symptoms but require different management strategies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires careful differentiation from other gastrointestinal disorders.
  • Treatment complexity: Involves dietary management and potential nutritional supplementation.
  • Documentation requirements: Detailed clinical history and symptom tracking are essential.
  • Coding specificity: Requires precise coding to reflect the specific type of enteropathy.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of enteropathy.
  • Documentation gaps: Incomplete dietary history or symptom documentation.
  • Billing challenges: Potential denials if the diagnosis is not clearly supported by clinical evidence.

Specialty Focus

Medical Specialties

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

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Food protein-induced enteropathy has significant clinical implications, particularly in pediatric populations where it can affect growth and development. Understanding the epidemiology of FPIE is crucial, as it is increasingly recognized in infants with a family history of allergies. Effective management can lead to improved health outcomes and reduced healthcare utilization, as timely diagnosis and dietary management can prevent complications associated with malnutrition.

ICD-9 vs ICD-10

Food protein-induced enteropathy has significant clinical implications, particularly in pediatric populations where it can affect growth and development. Understanding the epidemiology of FPIE is crucial, as it is increasingly recognized in infants with a family history of allergies. Effective management can lead to improved health outcomes and reduced healthcare utilization, as timely diagnosis and dietary management can prevent complications associated with malnutrition.

Reimbursement & Billing Impact

impact reimbursement. Familiarity with payer-specific guidelines is essential to avoid billing challenges.

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 K52.22?

K52.22 specifically covers food protein-induced enteropathy, which is an immune-mediated condition triggered by dietary proteins, primarily in infants and young children. It is distinct from other gastrointestinal conditions such as celiac disease or food allergies.

When should K52.22 be used instead of related codes?

K52.22 should be used when there is a confirmed diagnosis of food protein-induced enteropathy, particularly when symptoms are linked to specific dietary proteins. It is important to differentiate it from other conditions like food protein-induced enterocolitis (K52.21) based on the clinical presentation and diagnostic findings.

What documentation supports K52.22?

Documentation for K52.22 should include a thorough clinical history detailing the onset and duration of symptoms, dietary intake, results from elimination diets, and any diagnostic tests performed, such as endoscopy or biopsy findings that support the diagnosis of food protein-induced enteropathy.