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ICD-10 Guide
ICD-10 CodesK22.10

K22.10

Billable

Ulcer of esophagus without bleeding

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

Code Description

ICD-10 K22.10 is a billable code used to indicate a diagnosis of ulcer of esophagus without bleeding.

Key Diagnostic Point:

K22.10 refers to an ulcer of the esophagus without bleeding, a condition characterized by the formation of open sores on the lining of the esophagus. The esophagus is a muscular tube that connects the throat to the stomach, and ulcers can arise due to various factors, including gastroesophageal reflux disease (GERD), chronic irritation from medications, or infections. Clinically, patients may present with symptoms such as dysphagia (difficulty swallowing), odynophagia (painful swallowing), and retrosternal pain. The disease progression can lead to complications such as strictures or esophageal perforation if left untreated. Diagnostic considerations include endoscopy, which allows direct visualization of the esophagus, and biopsy to rule out malignancy. Imaging studies may also be employed to assess the extent of the ulceration and any associated complications. Early diagnosis and management are crucial to prevent further complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires endoscopic evaluation and possible biopsy.
  • Treatment complexity: May involve medications such as proton pump inhibitors or surgical intervention in severe cases.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary.
  • Coding specificity: Requires precise coding to differentiate from other esophageal conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with bleeding ulcers or other gastrointestinal conditions.
  • Documentation gaps: Incomplete clinical notes regarding symptoms or treatment plans.
  • Billing challenges: Potential denials if documentation does not clearly support the diagnosis.

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

Internal Medicine

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

The clinical significance of K22.10 lies in its potential to lead to serious complications if not managed appropriately. Population health impact includes a growing prevalence of esophageal conditions related to lifestyle factors such as diet and obesity. Quality measures may focus on timely diagnosis and effective management of esophageal ulcers to reduce hospitalizations. Understanding healthcare utilization patterns can help in resource allocation and improving patient care strategies for those affected by gastrointestinal disorders.

ICD-9 vs ICD-10

The clinical significance of K22.10 lies in its potential to lead to serious complications if not managed appropriately. Population health impact includes a growing prevalence of esophageal conditions related to lifestyle factors such as diet and obesity. Quality measures may focus on timely diagnosis and effective management of esophageal ulcers to reduce hospitalizations. Understanding healthcare utilization patterns can help in resource allocation and improving patient care strategies for those affected by gastrointestinal disorders.

Reimbursement & Billing Impact

Reimbursement considerations include the need for thorough clinical notes that justify the use of endoscopy and any associated procedures. Common denials may occur if the documentation does not clearly indicate the absence of bleeding or if the clinical rationale for the procedure is not well-articulated. Best practices include ensuring that all relevant symptoms and diagnostic findings are documented and that coding is accurate to avoid potential audits.

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 K22.10?

K22.10 specifically covers ulcers of the esophagus that do not involve bleeding. This includes ulcers caused by reflux, medications, or infections, but excludes any esophageal conditions that present with bleeding.

When should K22.10 be used instead of related codes?

K22.10 should be used when the diagnosis is confirmed as an esophageal ulcer without any evidence of bleeding. If bleeding is present, K22.11 should be selected instead.

What documentation supports K22.10?

Documentation should include clinical findings from patient history, physical examination, endoscopic reports, and any imaging studies that confirm the diagnosis of an esophageal ulcer without bleeding.