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ICD-10 Guide
ICD-10 CodesK83.01

K83.01

Billable

Primary sclerosing cholangitis

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

Code Description

ICD-10 K83.01 is a billable code used to indicate a diagnosis of primary sclerosing cholangitis.

Key Diagnostic Point:

Primary sclerosing cholangitis (PSC) is a chronic liver disease characterized by progressive inflammation and scarring of the bile ducts. It primarily affects the intrahepatic and extrahepatic bile ducts, leading to bile duct strictures and ultimately cholestasis. Clinically, patients may present with symptoms such as jaundice, pruritus, fatigue, and abdominal pain. The disease is often associated with inflammatory bowel disease, particularly ulcerative colitis. Over time, PSC can progress to liver cirrhosis and hepatocellular carcinoma, making early diagnosis and management crucial. Diagnostic considerations include liver function tests, imaging studies such as MRCP (Magnetic Resonance Cholangiopancreatography), and liver biopsy, which can reveal characteristic bile duct damage. The etiology of PSC remains largely unknown, but it is believed to involve autoimmune mechanisms. Regular monitoring and management of complications are essential for improving patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and possibly biopsy for confirmation.
  • Treatment complexity: Management may involve immunosuppressive therapy and monitoring for liver transplantation.
  • Documentation requirements: Detailed clinical history and ongoing monitoring are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other cholangitis types.

Audit Risk Factors

  • Common coding errors: Misclassification with other biliary disorders.
  • Documentation gaps: Incomplete clinical history or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient documentation of disease severity.

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

Hepatology

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

Primary sclerosing cholangitis has significant clinical implications, as it can lead to severe liver disease and complications such as liver failure and cancer. The prevalence of PSC is estimated to be around 6-16 cases per 100,000 individuals, with a notable association with inflammatory bowel disease. Understanding PSC's impact on population health is crucial for developing effective management strategies and improving patient outcomes. Quality measures should focus on early diagnosis, monitoring for complications, and appropriate referrals for liver transplantation.

ICD-9 vs ICD-10

Primary sclerosing cholangitis has significant clinical implications, as it can lead to severe liver disease and complications such as liver failure and cancer. The prevalence of PSC is estimated to be around 6-16 cases per 100,000 individuals, with a notable association with inflammatory bowel disease. Understanding PSC's impact on population health is crucial for developing effective management strategies and improving patient outcomes. Quality measures should focus on early diagnosis, monitoring for complications, and appropriate referrals for liver transplantation.

Reimbursement & Billing Impact

Reimbursement may be affected by the complexity of the case and the need for ongoing management. Common denials can occur if documentation does not clearly establish the diagnosis or if there is a lack of supporting evidence for treatment decisions. Coders should ensure that all relevant clinical information is included in the documentation to facilitate accurate billing and minimize audit risks.

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 K83.01?

K83.01 specifically covers primary sclerosing cholangitis, which is characterized by bile duct inflammation and scarring. It is important to differentiate it from secondary causes of cholangitis.

When should K83.01 be used instead of related codes?

K83.01 should be used when there is a confirmed diagnosis of primary sclerosing cholangitis, particularly when associated with inflammatory bowel disease. It should not be used for acute cholangitis or other biliary conditions.

What documentation supports K83.01?

Documentation should include clinical findings, imaging results (such as MRCP), liver function tests, and any associated conditions like inflammatory bowel disease. A detailed clinical history is essential.