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ICD-10 Guide
ICD-10 CodesK56.691

K56.691

Billable

Other complete intestinal obstruction

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

Code Description

ICD-10 K56.691 is a billable code used to indicate a diagnosis of other complete intestinal obstruction.

Key Diagnostic Point:

K56.691 refers to 'Other complete intestinal obstruction,' a condition characterized by a total blockage of the intestinal lumen, preventing the passage of intestinal contents. This obstruction can occur in any part of the intestines, including the small intestine and colon, and may result from various causes such as adhesions, tumors, hernias, or inflammatory bowel diseases. Clinically, patients may present with symptoms such as severe abdominal pain, distension, vomiting, constipation, and inability to pass gas. The anatomy involved includes the entire gastrointestinal tract, particularly the sections where the obstruction occurs. Disease progression can lead to complications such as bowel ischemia, perforation, and sepsis if not promptly diagnosed and treated. Diagnostic considerations include imaging studies like X-rays, CT scans, and ultrasounds to identify the location and cause of the obstruction. Laboratory tests may also be performed to assess electrolyte imbalances and signs of infection.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misidentifying the type of obstruction.
  • Documentation gaps may arise if the cause of obstruction is not clearly stated.
  • Billing challenges can occur if the medical necessity for procedures related to the obstruction is not well-documented.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K56.691 lies in its potential to lead to severe complications if not treated promptly. Intestinal obstruction affects a significant portion of the population, particularly among older adults and those with underlying gastrointestinal disorders. Understanding the epidemiology of this condition can aid in developing quality measures and improving healthcare utilization patterns, ultimately enhancing patient outcomes and reducing hospital readmission rates.

ICD-9 vs ICD-10

The clinical significance of K56.691 lies in its potential to lead to severe complications if not treated promptly. Intestinal obstruction affects a significant portion of the population, particularly among older adults and those with underlying gastrointestinal disorders. Understanding the epidemiology of this condition can aid in developing quality measures and improving healthcare utilization patterns, ultimately enhancing patient outcomes and reducing hospital readmission rates.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for surgical interventions and ensuring that all relevant codes are submitted accurately. Common denials may arise from insufficient documentation or failure to demonstrate the medical necessity of the treatment provided. Best practices include maintaining thorough clinical notes, ensuring that all diagnostic tests and imaging are documented, and using precise coding to reflect the patient's condition.

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 K56.691?

K56.691 encompasses various conditions leading to complete intestinal obstruction, including but not limited to adhesions, tumors, volvulus, and strictures. It is essential to document the specific cause to ensure accurate coding.

When should K56.691 be used instead of related codes?

K56.691 should be used when there is a confirmed diagnosis of complete intestinal obstruction with a specified cause. If the obstruction is unspecified, K56.690 should be utilized instead.

What documentation supports K56.691?

Documentation should include clinical findings, imaging results, surgical reports if applicable, and a clear statement of the cause of the obstruction. Detailed notes on the patient's symptoms and treatment plan are also crucial.