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ICD-10 Guide
ICD-10 CodesK56.4

K56.4

Non-billable

Other impaction of intestine

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

Code Description

ICD-10 K56.4 is a used to indicate a diagnosis of other impaction of intestine.

Key Diagnostic Point:

K56.4 refers to 'Other impaction of intestine,' a condition characterized by the obstruction of the intestinal lumen due to various factors other than the more common causes such as fecal impaction or foreign bodies. Clinically, patients may present with symptoms including abdominal pain, distension, nausea, vomiting, and changes in bowel habits. The anatomy involved typically includes the small intestine or large intestine, where the impaction can occur at any segment. Disease progression can lead to severe complications such as bowel ischemia, perforation, or sepsis if not addressed promptly. Diagnostic considerations include imaging studies such as X-rays, CT scans, or ultrasounds to visualize the obstruction and assess its cause. Laboratory tests may also be performed to evaluate for signs of infection or electrolyte imbalances. Proper identification of the underlying cause of the impaction is crucial for effective treatment and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to determine the cause of impaction.
  • Treatment complexity: May involve conservative management or surgical intervention depending on severity.
  • Documentation requirements: Detailed clinical notes and imaging results are necessary for accurate coding.
  • Coding specificity: Requires differentiation from other types of intestinal obstruction codes.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of obstruction.
  • Documentation gaps: Incomplete clinical notes regarding the cause and treatment of impaction.
  • Billing challenges: Potential denials due to lack of specificity in documentation.

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 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 K56.4 lies in its potential to lead to severe complications if not diagnosed and treated promptly. Population health impact includes a notable prevalence of gastrointestinal disorders that can result in increased healthcare utilization patterns, such as emergency visits and surgical interventions. Understanding the epidemiology of intestinal impaction can aid in developing quality measures and improving patient outcomes.

ICD-9 vs ICD-10

The clinical significance of K56.4 lies in its potential to lead to severe complications if not diagnosed and treated promptly. Population health impact includes a notable prevalence of gastrointestinal disorders that can result in increased healthcare utilization patterns, such as emergency visits and surgical interventions. Understanding the epidemiology of intestinal impaction can aid in developing quality measures and improving patient outcomes.

Reimbursement & Billing Impact

impaction. Reimbursement considerations include the need for detailed clinical notes that outline the patient's symptoms, diagnostic imaging results, and treatment plans. Common denials may arise from insufficient documentation or failure to specify the cause of the impaction. Coders should ensure that all relevant information is included in the medical record to support the billing process and reduce the risk of 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 K56.4?

K56.4 encompasses various conditions leading to intestinal impaction, including but not limited to, strictures, tumors, and foreign body ingestion that do not fall under more specific codes. It is essential to identify the underlying cause to ensure appropriate management.

When should K56.4 be used instead of related codes?

K56.4 should be used when the impaction is not due to fecal matter or a foreign body, and when the specific cause of the obstruction is not classified under other codes. It is important to document the clinical findings that support this diagnosis.

What documentation supports K56.4?

Documentation should include clinical notes detailing the patient's symptoms, results from imaging studies, and any laboratory tests performed. Clear identification of the cause of impaction and the treatment plan is crucial for supporting the use of this code.