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ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK56

K56

Non-billable

Paralytic ileus and intestinal obstruction without hernia

Chapter 11:Diseases of the digestive system

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

Code Description

ICD-10 K56 is a used to indicate a diagnosis of paralytic ileus and intestinal obstruction without hernia.

Key Diagnostic Point:

K56 refers to paralytic ileus and intestinal obstruction without hernia, conditions characterized by a lack of intestinal motility leading to the accumulation of intestinal contents. Clinically, patients may present with symptoms such as abdominal distension, pain, nausea, vomiting, and constipation. The anatomy involved includes the small and large intestines, where the obstruction can occur at any point. Disease progression can vary; in some cases, it may resolve spontaneously, while in others, it can lead to serious complications such as bowel ischemia or perforation if not addressed promptly. Diagnostic considerations include imaging studies like X-rays or CT scans to identify the obstruction and assess its severity. Laboratory tests may also be performed to evaluate electrolyte imbalances and signs of infection. Understanding the underlying cause, which may include postoperative states, electrolyte imbalances, or medications, is crucial for effective management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation to determine the cause of ileus or obstruction.
  • Treatment complexity: Management may involve conservative measures or surgical intervention depending on severity.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires accurate coding to differentiate between types of obstruction and underlying causes.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of obstruction or failure to document the cause.
  • Documentation gaps: Incomplete clinical notes that do not support the diagnosis.
  • Billing challenges: Potential denials due to lack of clear documentation or coding errors.

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

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CPT Code

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CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K56 lies in its potential to lead to serious complications if not managed appropriately. Population health impact includes increased hospital admissions and healthcare utilization due to the need for diagnostic imaging and potential surgical interventions. Quality measures may focus on timely diagnosis and management to prevent complications. Epidemiologically, understanding the prevalence of paralytic ileus and intestinal obstruction can help in resource allocation and improving patient care strategies.

ICD-9 vs ICD-10

The clinical significance of K56 lies in its potential to lead to serious complications if not managed appropriately. Population health impact includes increased hospital admissions and healthcare utilization due to the need for diagnostic imaging and potential surgical interventions. Quality measures may focus on timely diagnosis and management to prevent complications. Epidemiologically, understanding the prevalence of paralytic ileus and intestinal obstruction can help in resource allocation and improving patient care strategies.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the interventions performed, whether conservative or surgical. Common denials may arise from insufficient documentation or coding errors, so it is essential to ensure that all clinical notes are thorough and accurately reflect the patient's condition. Best practices include regular audits of coding accuracy and ensuring that all relevant clinical information is included in the patient’s medical record.

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 K56?

K56 encompasses conditions such as paralytic ileus, functional intestinal obstruction, and mechanical obstruction without hernia. It is important to differentiate these from other gastrointestinal disorders.

When should K56 be used instead of related codes?

K56 should be used when the obstruction is not due to a hernia and is primarily due to motility issues or other non-mechanical factors. It is essential to evaluate the clinical presentation and diagnostic findings.

What documentation supports K56?

Documentation should include clinical findings, imaging results, and any interventions performed. Clear notes on the patient's symptoms, history, and treatment response are critical for supporting the use of K56.