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v1.0.0
ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK63

K63

Non-billable

Other diseases of intestine

Chapter 11:Diseases of the digestive system

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

Code Description

ICD-10 K63 is a used to indicate a diagnosis of other diseases of intestine.

Key Diagnostic Point:

K63 encompasses a variety of intestinal diseases that do not fall under more specific categories. This code is used for conditions affecting the intestines, including diverticulitis, intestinal obstruction, and other non-specific intestinal disorders. Clinically, patients may present with symptoms such as abdominal pain, bloating, changes in bowel habits, and gastrointestinal bleeding. The intestines, which include both the small and large intestines, are critical for digestion and nutrient absorption. Disease progression can vary widely; some conditions may be acute and self-limiting, while others can lead to chronic complications requiring surgical intervention. Diagnostic considerations include imaging studies such as CT scans, endoscopy, and laboratory tests to rule out infections or malignancies. Accurate diagnosis is essential for effective treatment planning and to avoid complications such as perforation or sepsis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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 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

Conditions classified under K63 can significantly affect population health, as they may lead to increased healthcare utilization, including emergency visits and hospital admissions. Understanding the epidemiology of these intestinal diseases helps in developing quality measures and preventive strategies. Effective management of these conditions can improve patient outcomes and reduce the burden on healthcare systems.

ICD-9 vs ICD-10

Conditions classified under K63 can significantly affect population health, as they may lead to increased healthcare utilization, including emergency visits and hospital admissions. Understanding the epidemiology of these intestinal diseases helps in developing quality measures and preventive strategies. Effective management of these conditions can improve patient outcomes and reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the condition and the treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Coders should ensure that all relevant clinical information is included in the medical record to support the diagnosis and any associated procedures. Best practices include regular training on coding updates and thorough reviews of documentation before submission.

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 K63?

K63 covers a range of conditions including but not limited to diverticulitis, intestinal obstruction, and other unspecified diseases of the intestine. It is important to document the specific nature of the condition to ensure appropriate coding.

When should K63 be used instead of related codes?

K63 should be used when the intestinal condition does not fit into more specific categories. For example, if a patient has a non-specific intestinal disease without a clear diagnosis, K63 is appropriate. In contrast, if a specific diagnosis like diverticulitis is made, a more specific code should be used.

What documentation supports K63?

Documentation should include clinical findings, diagnostic imaging results, laboratory tests, and a clear description of the patient's symptoms. Detailed notes on the patient's history and any treatments provided are also essential to support the use of K63.