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ICD-10 Guide
ICD-10 CodesK52.838

K52.838

Billable

Other microscopic colitis

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

Code Description

ICD-10 K52.838 is a billable code used to indicate a diagnosis of other microscopic colitis.

Key Diagnostic Point:

K52.838 refers to other microscopic colitis, a condition characterized by chronic diarrhea that is often non-bloody and can be associated with abdominal pain. Microscopic colitis is an inflammatory condition of the colon that is diagnosed through histological examination of colonic biopsies, revealing inflammation that is not visible during standard endoscopy. The anatomy involved primarily includes the colon, where inflammation can disrupt normal bowel function. Disease progression may vary; some patients experience intermittent symptoms, while others may have persistent diarrhea that significantly impacts their quality of life. Diagnostic considerations include ruling out other causes of diarrhea, such as infections or inflammatory bowel disease, and confirming the diagnosis through biopsy. Patients may also present with associated symptoms like weight loss, fatigue, and malnutrition due to fluid loss and dietary restrictions. Treatment typically involves dietary modifications, medications such as anti-diarrheal agents, and in some cases, corticosteroids to reduce inflammation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires histological confirmation and differentiation from other gastrointestinal disorders.
  • Treatment complexity: Management may involve multiple therapeutic approaches and dietary changes.
  • Documentation requirements: Detailed clinical notes and biopsy results are essential for accurate coding.
  • Coding specificity: Requires precise coding to differentiate from other forms of colitis.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of colitis or gastroenteritis.
  • Documentation gaps: Insufficient biopsy reports or clinical notes to support the diagnosis.
  • Billing challenges: Potential denials if documentation does not clearly establish the diagnosis.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: Pathology

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

Microscopic colitis, including K52.838, has significant clinical implications as it affects a growing population, particularly older adults. The condition can lead to increased healthcare utilization due to frequent medical visits, diagnostic procedures, and potential hospitalizations. Understanding and accurately coding this condition is crucial for quality measures and population health management, as it can impact treatment approaches and patient outcomes.

ICD-9 vs ICD-10

Microscopic colitis, including K52.838, has significant clinical implications as it affects a growing population, particularly older adults. The condition can lead to increased healthcare utilization due to frequent medical visits, diagnostic procedures, and potential hospitalizations. Understanding and accurately coding this condition is crucial for quality measures and population health management, as it can impact treatment approaches and patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the payer, but it is essential to ensure that all documentation supports the diagnosis of microscopic colitis. Common denials may occur if the documentation does not clearly establish the diagnosis or if there are discrepancies in the coding. Best practices include thorough documentation of all clinical encounters and ensuring that the coding accurately reflects the patient's condition 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 K52.838?

K52.838 covers cases of microscopic colitis that do not fit into the more specific categories of lymphocytic or collagenous colitis. It includes patients with chronic diarrhea and inflammation confirmed through biopsy but without the specific histological features of the aforementioned types.

When should K52.838 be used instead of related codes?

K52.838 should be used when a patient presents with symptoms of colitis and has undergone biopsy confirming inflammation that does not meet the criteria for lymphocytic or collagenous colitis. It is important to differentiate based on histological findings.

What documentation supports K52.838?

Documentation supporting K52.838 includes detailed clinical notes outlining the patient's symptoms, results from colonoscopy, and biopsy findings that confirm inflammation without specific histological characteristics of other colitis types.