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ICD-10 Guide
ICD-10 CodesK11.22

K11.22

Billable

Acute recurrent sialoadenitis

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

Code Description

ICD-10 K11.22 is a billable code used to indicate a diagnosis of acute recurrent sialoadenitis.

Key Diagnostic Point:

Acute recurrent sialoadenitis is characterized by episodes of inflammation of the salivary glands, primarily affecting the parotid gland. Clinically, patients may present with swelling, pain, and tenderness in the affected area, often accompanied by fever and malaise. The condition can be triggered by dehydration, obstruction of the salivary duct, or infection, leading to recurrent episodes of inflammation. Anatomically, the parotid, submandibular, and sublingual glands are involved, with the parotid gland being the most commonly affected. Disease progression can vary, with some patients experiencing frequent recurrences, while others may have isolated incidents. Diagnostic considerations include clinical evaluation, imaging studies such as ultrasound or MRI, and laboratory tests to identify potential infectious agents. A thorough history and physical examination are essential to differentiate acute recurrent sialoadenitis from other salivary gland disorders, such as chronic sialadenitis or neoplasms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis from other salivary gland disorders.
  • Treatment complexity: May involve antibiotics, hydration, and surgical intervention in severe cases.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires accurate coding to reflect the recurrent nature of the condition.

Audit Risk Factors

  • Common coding errors: Misclassification of acute vs. chronic conditions.
  • Documentation gaps: Incomplete clinical notes regarding recurrence.
  • Billing challenges: Potential denials if documentation does not support the recurrent nature.

Specialty Focus

Medical Specialties

Primary medical specialty: Otolaryngology

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: Dentistry

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

Acute recurrent sialoadenitis can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. Understanding the epidemiology of this condition is essential, as it may affect various populations differently, particularly those with underlying health issues that predispose them to dehydration or salivary duct obstruction. Quality measures should focus on timely diagnosis and effective management to reduce recurrence rates and improve patient outcomes.

ICD-9 vs ICD-10

Acute recurrent sialoadenitis can significantly impact patient quality of life due to pain and discomfort, leading to increased healthcare utilization. Understanding the epidemiology of this condition is essential, as it may affect various populations differently, particularly those with underlying health issues that predispose them to dehydration or salivary duct obstruction. Quality measures should focus on timely diagnosis and effective management to reduce recurrence rates and improve patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the documentation clearly supports the diagnosis and the need for any procedures performed. Common denials may arise from insufficient documentation or failure to demonstrate the recurrent nature of the condition. Coders should ensure that all relevant clinical information is included in the medical record to support the claim and avoid billing challenges.

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 K11.22?

K11.22 specifically covers acute recurrent sialoadenitis, which involves repeated episodes of inflammation in the salivary glands, primarily the parotid gland, often due to infection or obstruction.

When should K11.22 be used instead of related codes?

K11.22 should be used when the patient presents with recurrent episodes of acute sialoadenitis, differentiating it from chronic conditions or single episodes of acute sialoadenitis.

What documentation supports K11.22?

Documentation should include clinical findings of recurrent episodes, imaging results, treatment history, and any laboratory tests that confirm infection or obstruction.