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ICD-10 Guide
ICD-10 CodesK64.4

K64.4

Billable

Residual hemorrhoidal skin tags

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

Code Description

ICD-10 K64.4 is a billable code used to indicate a diagnosis of residual hemorrhoidal skin tags.

Key Diagnostic Point:

Residual hemorrhoidal skin tags are benign growths that can occur following the resolution of hemorrhoids, particularly after surgical interventions or spontaneous resolution of external hemorrhoids. Clinically, these tags may present as small, soft, and often asymptomatic protrusions of skin around the anal region. They are remnants of the tissue that once formed part of the hemorrhoid and can vary in size and number. Anatomically, they arise from the anal margin and may be associated with discomfort, hygiene issues, or cosmetic concerns. Disease progression is typically benign, but these tags can become irritated or inflamed, leading to secondary complications. Diagnostic considerations include a thorough physical examination and, if necessary, anoscopy to rule out other conditions such as anal fissures or malignancies. It is important to differentiate residual skin tags from active hemorrhoidal disease, as treatment approaches may differ significantly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as differential diagnosis is necessary.
  • Treatment complexity: Low, typically involves minor surgical procedures if symptomatic.
  • Documentation requirements: Moderate, requires clear documentation of symptoms and treatment rationale.
  • Coding specificity: High, specific to residual skin tags post-hemorrhoid treatment.

Audit Risk Factors

  • Common coding errors: Misclassification of active hemorrhoids instead of residual tags.
  • Documentation gaps: Incomplete records regarding previous hemorrhoidal treatments.
  • Billing challenges: Potential denials if the relationship between the skin tags and prior hemorrhoidal disease is not clearly established.

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: Colorectal 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

Residual hemorrhoidal skin tags, while generally benign, can impact patient quality of life due to discomfort or hygiene issues. Understanding the prevalence of this condition can help healthcare providers address patient concerns effectively. Proper coding and documentation are essential for tracking healthcare utilization patterns and ensuring that patients receive appropriate care. Epidemiologically, the presence of residual skin tags may indicate a history of hemorrhoidal disease, which is common in the population, thus highlighting the need for preventive measures and education.

ICD-9 vs ICD-10

Residual hemorrhoidal skin tags, while generally benign, can impact patient quality of life due to discomfort or hygiene issues. Understanding the prevalence of this condition can help healthcare providers address patient concerns effectively. Proper coding and documentation are essential for tracking healthcare utilization patterns and ensuring that patients receive appropriate care. Epidemiologically, the presence of residual skin tags may indicate a history of hemorrhoidal disease, which is common in the population, thus highlighting the need for preventive measures and education.

Reimbursement & Billing Impact

Reimbursement considerations may vary by payer, so it is essential to verify coverage policies. Common denials may arise if the relationship between the skin tags and previous hemorrhoidal disease is not adequately documented. Best practices include providing detailed clinical notes, including the history of the condition, treatment rationale, and any relevant patient symptoms. Accurate coding and thorough documentation can help mitigate billing challenges and ensure appropriate 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 K64.4?

K64.4 specifically covers residual hemorrhoidal skin tags that occur after the resolution of hemorrhoids. It does not cover active hemorrhoidal disease or other anal conditions.

When should K64.4 be used instead of related codes?

K64.4 should be used when documenting residual skin tags that are not symptomatic or when they are a direct result of previous hemorrhoidal disease. It is important to differentiate from active hemorrhoids or other anal conditions.

What documentation supports K64.4?

Documentation should include a history of hemorrhoidal disease, details of any prior treatments, and a physical examination noting the presence of skin tags. Any symptoms related to the tags should also be documented.