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ICD-10 Guide
ICD-10 CodesK56.5

K56.5

Non-billable

Intestinal adhesions [bands] with obstruction (postinfection)

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

Code Description

ICD-10 K56.5 is a used to indicate a diagnosis of intestinal adhesions [bands] with obstruction (postinfection).

Key Diagnostic Point:

K56.5 refers to intestinal adhesions (bands) with obstruction, typically occurring post-infection. These adhesions are fibrous bands that form between abdominal tissues and organs, often as a result of previous surgeries, infections, or inflammation. Clinically, patients may present with symptoms such as abdominal pain, bloating, nausea, vomiting, and changes in bowel habits. The anatomy involved includes the intestines, peritoneum, and surrounding structures. Disease progression can lead to significant complications, including bowel ischemia or perforation if not addressed promptly. Diagnostic considerations include imaging studies such as CT scans or ultrasounds to visualize the obstruction and assess the extent of adhesions. A thorough patient history and physical examination are essential to differentiate between adhesive obstruction and other causes of gastrointestinal obstruction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm diagnosis.
  • Treatment complexity: May necessitate surgical intervention, which can vary in complexity.
  • Documentation requirements: Detailed documentation of symptoms, imaging results, and treatment plans is crucial.
  • Coding specificity: Requires accurate coding to reflect the presence of obstruction and its post-infectious nature.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of obstruction or failure to specify post-infection.
  • Documentation gaps: Incomplete records regarding the patient's surgical history or symptomatology.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis of K56.5.

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

General Surgery

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 K56.5 lies in its potential to cause severe gastrointestinal complications, impacting patient quality of life and healthcare utilization. Intestinal obstructions can lead to increased hospital admissions, surgical interventions, and prolonged recovery times. Understanding the epidemiology of post-infectious adhesions is crucial for developing preventive strategies and improving patient outcomes in the population.

ICD-9 vs ICD-10

The clinical significance of K56.5 lies in its potential to cause severe gastrointestinal complications, impacting patient quality of life and healthcare utilization. Intestinal obstructions can lead to increased hospital admissions, surgical interventions, and prolonged recovery times. Understanding the epidemiology of post-infectious adhesions is crucial for developing preventive strategies and improving patient outcomes in the population.

Reimbursement & Billing Impact

reimbursement.

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 K56.5?

K56.5 covers intestinal obstructions specifically due to adhesions formed post-infection. This includes cases where previous abdominal surgeries or infections have led to the formation of fibrous bands causing blockage in the intestines.

When should K56.5 be used instead of related codes?

K56.5 should be used when there is a clear diagnosis of intestinal obstruction due to adhesions specifically linked to a post-infectious process. If the obstruction is due to other causes, such as tumors or hernias, different codes should be considered.

What documentation supports K56.5?

Documentation should include a detailed history of prior infections or surgeries, imaging results confirming the presence of adhesions and obstruction, and clinical notes outlining the patient's symptoms and treatment plan.