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ICD-10 Guide
ICD-10 CodesK62.89

K62.89

Billable

Other specified diseases of anus and rectum

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

Code Description

ICD-10 K62.89 is a billable code used to indicate a diagnosis of other specified diseases of anus and rectum.

Key Diagnostic Point:

K62.89 refers to 'Other specified diseases of anus and rectum,' which encompasses a variety of conditions affecting the anal and rectal regions not classified elsewhere. These may include conditions such as anal fissures, rectal prolapse, and other less common disorders. Clinically, patients may present with symptoms such as rectal bleeding, pain during defecation, or changes in bowel habits. The anatomy involved primarily includes the anal canal, rectum, and surrounding tissues. Disease progression can vary; for instance, an anal fissure may become chronic if not treated, leading to significant discomfort and complications. Diagnostic considerations include a thorough history and physical examination, possibly supplemented by imaging studies or endoscopy to rule out other conditions. Accurate diagnosis is crucial as it influences treatment options, which may range from conservative management to surgical interventions depending on the severity and underlying cause of the symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Conditions under K62.89 can vary widely, requiring careful assessment to determine the specific diagnosis.
  • Treatment complexity: Treatment may involve multiple specialties, including gastroenterology and colorectal surgery, depending on the condition.
  • Documentation requirements: Comprehensive documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: While K62.89 allows for some specificity, it may require additional codes for complete representation of the patient's condition.

Audit Risk Factors

  • Common coding errors: Misapplication of K62.89 instead of more specific codes can lead to inaccuracies.
  • Documentation gaps: Incomplete clinical notes may result in challenges during audits.
  • Billing challenges: Lack of clarity in the diagnosis can lead to claim denials or delays in reimbursement.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: Colorectal 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 K62.89 lies in its association with various anal and rectal disorders that can significantly affect a patient's quality of life. These conditions can lead to complications if left untreated, impacting population health. Understanding the epidemiology of these diseases can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to the management of these conditions can improve healthcare utilization patterns and overall patient outcomes.

ICD-9 vs ICD-10

The clinical significance of K62.89 lies in its association with various anal and rectal disorders that can significantly affect a patient's quality of life. These conditions can lead to complications if left untreated, impacting population health. Understanding the epidemiology of these diseases can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to the management of these conditions can improve healthcare utilization patterns and overall patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis aligns with the services rendered. Common denials may arise from insufficient documentation or lack of specificity in the diagnosis. It is crucial to provide comprehensive clinical notes that detail the patient's condition and treatment plan to avoid billing challenges. Adhering to coding best practices, such as using the most specific codes available and ensuring accurate documentation, can enhance the likelihood of successful claims.

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 K62.89?

K62.89 includes conditions such as anal abscess, anal fistula, rectal ulcers, and other specified diseases that do not have a dedicated code. Each condition has specific diagnostic criteria that must be met for accurate coding.

When should K62.89 be used instead of related codes?

K62.89 should be used when the specific condition affecting the anus or rectum does not have a dedicated code. It is important to ensure that the documentation supports the use of this code and that more specific codes are not applicable.

What documentation supports K62.89?

Documentation should include a detailed clinical history, physical examination findings, diagnostic test results, and treatment plans. Clear notes on the patient's symptoms and any interventions performed are essential to justify the use of K62.89.