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ICD-10 Guide
ICD-10 CodesK59.81

K59.81

Billable

Ogilvie syndrome

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

Code Description

ICD-10 K59.81 is a billable code used to indicate a diagnosis of ogilvie syndrome.

Key Diagnostic Point:

Ogilvie syndrome, also known as acute colonic pseudo-obstruction, is a condition characterized by a significant dilation of the colon without any mechanical obstruction. Clinically, patients may present with abdominal distension, pain, nausea, and vomiting. The syndrome primarily affects the large intestine, particularly the cecum and proximal colon, leading to a functional obstruction. The etiology is often multifactorial, including factors such as electrolyte imbalances, medications (especially opioids), and underlying medical conditions like diabetes or neurological disorders. Disease progression can vary, with some patients experiencing spontaneous resolution, while others may require medical or surgical intervention. Diagnostic considerations include imaging studies such as abdominal X-rays or CT scans to rule out mechanical obstruction and assess colonic dilation. Laboratory tests may also be performed to identify electrolyte imbalances or other contributing factors. Early recognition and management are crucial to prevent complications such as colonic perforation or ischemia.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to differentiate from mechanical obstruction.
  • Treatment complexity: Management may involve conservative measures, medications, or surgical intervention.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential for accurate coding.
  • Coding specificity: Requires precise documentation of symptoms and diagnostic findings.

Audit Risk Factors

  • Common coding errors: Misclassification with other gastrointestinal disorders.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials if documentation does not support the diagnosis.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Ogilvie syndrome can significantly impact patient health, leading to complications if not managed promptly. It is essential for healthcare providers to recognize this condition to prevent adverse outcomes such as colonic perforation. The syndrome may contribute to increased healthcare utilization, including hospital admissions and surgical interventions. Understanding its epidemiology is crucial, as it can occur in various populations, particularly among those with underlying health issues or after certain surgical procedures.

ICD-9 vs ICD-10

Ogilvie syndrome can significantly impact patient health, leading to complications if not managed promptly. It is essential for healthcare providers to recognize this condition to prevent adverse outcomes such as colonic perforation. The syndrome may contribute to increased healthcare utilization, including hospital admissions and surgical interventions. Understanding its epidemiology is crucial, as it can occur in various populations, particularly among those with underlying health issues or after certain surgical procedures.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by thorough documentation, as insurers may deny claims if the medical necessity is not clearly established. Common denials may arise from insufficient documentation or misclassification of the condition. Best practices include maintaining detailed clinical notes, ensuring imaging results are included in the patient record, and using the most specific code available to accurately reflect the patient's condition.

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 K59.81?

K59.81 specifically covers Ogilvie syndrome, which is characterized by colonic dilation without mechanical obstruction. It may be associated with various underlying conditions, including electrolyte imbalances, medications, and systemic diseases.

When should K59.81 be used instead of related codes?

K59.81 should be used when there is clear evidence of colonic dilation without obstruction, as confirmed by imaging studies. It is distinct from codes for mechanical obstruction or other gastrointestinal disorders.

What documentation supports K59.81?

Documentation should include clinical findings such as abdominal distension and pain, imaging results showing colonic dilation, and any relevant laboratory tests that may indicate underlying causes.