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ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK83

K83

Non-billable

Other diseases of biliary tract

Chapter 11:Diseases of the digestive system

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

Code Description

ICD-10 K83 is a used to indicate a diagnosis of other diseases of biliary tract.

Key Diagnostic Point:

K83 encompasses a variety of diseases affecting the biliary tract, which includes the gallbladder, bile ducts, and associated structures. Common clinical presentations may include biliary colic, jaundice, and cholangitis. The anatomy involved primarily consists of the gallbladder, common bile duct, and hepatic ducts. Disease progression can vary widely, from acute conditions such as choledocholithiasis (bile duct stones) to chronic issues like biliary strictures or primary sclerosing cholangitis. Diagnostic considerations often involve imaging studies such as ultrasound, CT scans, or MRCP to visualize the biliary system and identify obstructions or lesions. Laboratory tests may also be utilized to assess liver function and detect cholestasis. Accurate diagnosis is crucial, as the management of biliary tract diseases can range from conservative treatment to surgical interventions, depending on the underlying cause and severity of the condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Varies based on the specific biliary condition and may require advanced imaging.
  • Treatment complexity: Treatment options can range from medication to surgical procedures, necessitating careful planning.
  • Documentation requirements: Requires thorough documentation of clinical findings, imaging results, and treatment plans.
  • Coding specificity: While K83 is specific, differentiating between various biliary conditions may require additional codes.

Audit Risk Factors

  • Common coding errors: Misclassification of biliary conditions or failure to specify the type of disease.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results to support the diagnosis.
  • Billing challenges: Potential for denials if documentation does not clearly justify the medical necessity of procedures.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K83 lies in its association with various biliary tract diseases that can lead to severe complications if left untreated. These conditions can significantly impact population health, leading to increased healthcare utilization and costs. Quality measures often focus on timely diagnosis and treatment of biliary diseases to prevent complications such as cholangitis or pancreatitis. Understanding the epidemiology of these conditions helps in developing targeted interventions and improving patient outcomes.

ICD-9 vs ICD-10

The clinical significance of K83 lies in its association with various biliary tract diseases that can lead to severe complications if left untreated. These conditions can significantly impact population health, leading to increased healthcare utilization and costs. Quality measures often focus on timely diagnosis and treatment of biliary diseases to prevent complications such as cholangitis or pancreatitis. Understanding the epidemiology of these conditions helps in developing targeted interventions and improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement may vary based on the complexity of the condition and the interventions required. Common denials can occur if the documentation does not clearly outline the diagnosis and treatment rationale. Coders should ensure that all relevant clinical information is included in the claim to minimize the risk of denials 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 K83?

K83 covers various biliary tract diseases including biliary obstruction, cholangitis, biliary fistula, and primary sclerosing cholangitis. Each condition has specific diagnostic criteria that must be met for accurate coding.

When should K83 be used instead of related codes?

K83 should be used when the condition does not fit into more specific categories like K80 or K81. It is appropriate for cases involving other biliary diseases that do not have a dedicated code.

What documentation supports K83?

Documentation should include clinical findings, imaging studies, laboratory results, and a clear treatment plan. Detailed notes on the patient's history and symptoms are also essential.