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ICD-10 Guide
ICD-10 CodesK94.2

K94.2

Non-billable

Gastrostomy complications

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

Code Description

ICD-10 K94.2 is a used to indicate a diagnosis of gastrostomy complications.

Key Diagnostic Point:

K94.2 refers to complications arising from gastrostomy procedures, which are surgical openings created in the stomach for feeding purposes. Common clinical presentations include infection at the stoma site, leakage of gastric contents, and obstruction of the feeding tube. The anatomy involved primarily includes the stomach and the abdominal wall where the gastrostomy tube is placed. Disease progression can vary; complications may arise immediately post-surgery or develop over time due to tube dislodgement or infection. Diagnostic considerations include clinical evaluation of symptoms such as fever, abdominal pain, or drainage from the stoma, and may involve imaging studies to assess for obstruction or other complications. Proper identification of these complications is crucial for effective management and to prevent further morbidity.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires understanding of post-surgical complications and their management.
  • Treatment complexity: May involve surgical intervention, antibiotic therapy, or tube replacement.
  • Documentation requirements: Detailed clinical notes and follow-up assessments are necessary.
  • Coding specificity: Requires accurate coding to differentiate between types of complications.

Audit Risk Factors

  • Common coding errors: Misidentifying the complication type or failing to document the reason for the gastrostomy.
  • Documentation gaps: Incomplete records regarding the patient's post-operative status and complications.
  • Billing challenges: Incorrect coding may lead to claim denials or reduced reimbursement.

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

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K94.2 lies in its ability to capture the complications of gastrostomy, which can significantly affect patient outcomes and quality of life. Understanding these complications is vital for improving population health, as they can lead to increased healthcare utilization and costs. Monitoring these complications can also inform quality measures and enhance care protocols for patients requiring gastrostomy.

ICD-9 vs ICD-10

The clinical significance of K94.2 lies in its ability to capture the complications of gastrostomy, which can significantly affect patient outcomes and quality of life. Understanding these complications is vital for improving population health, as they can lead to increased healthcare utilization and costs. Monitoring these complications can also inform quality measures and enhance care protocols for patients requiring gastrostomy.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of detailed clinical notes that justify the use of this code. Common denials may arise from insufficient documentation or failure to provide evidence of the complication's impact on patient care. Best practices include thorough documentation of the patient's condition, treatment provided, and any follow-up care required to mitigate complications.

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 K94.2?

K94.2 covers complications such as infection, leakage, obstruction, and dislodgement of the gastrostomy tube. It is important to document the specific complication for accurate coding.

When should K94.2 be used instead of related codes?

K94.2 should be used when there are documented complications directly related to the gastrostomy procedure. If there are no complications, other codes may be more appropriate.

What documentation supports K94.2?

Documentation should include clinical findings, treatment plans, and follow-up assessments that detail the nature of the complications and the patient's response to treatment.