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ICD-10 Guide
ICD-10 CodesK63.822

K63.822

Billable

Small intestinal fungal overgrowth

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

Code Description

ICD-10 K63.822 is a billable code used to indicate a diagnosis of small intestinal fungal overgrowth.

Key Diagnostic Point:

Small intestinal fungal overgrowth (SIFO) is a condition characterized by an abnormal increase in fungal organisms, primarily Candida species, in the small intestine. Clinically, patients may present with symptoms such as bloating, abdominal pain, diarrhea, and malabsorption, which can lead to nutritional deficiencies. The small intestine, which plays a crucial role in digestion and nutrient absorption, can become compromised due to various factors, including antibiotic use, immunosuppression, and underlying gastrointestinal disorders like irritable bowel syndrome or Crohn's disease. Disease progression can lead to chronic gastrointestinal symptoms and may contribute to systemic issues if left untreated. Diagnosis often involves a combination of clinical evaluation, stool tests, and sometimes endoscopic procedures to assess fungal presence. It is important to differentiate SIFO from other gastrointestinal conditions, such as small intestinal bacterial overgrowth (SIBO), as treatment approaches may differ significantly. Accurate diagnosis is essential for effective management and to prevent complications associated with prolonged fungal overgrowth.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

Infectious Disease

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 small intestinal fungal overgrowth lies in its potential to cause chronic gastrointestinal symptoms and nutritional deficiencies, impacting patient quality of life. Understanding SIFO is crucial for population health, as it may be underdiagnosed and mismanaged, leading to increased healthcare utilization. Epidemiologically, the condition may be more prevalent in immunocompromised populations, necessitating awareness and appropriate management strategies to improve health outcomes.

ICD-9 vs ICD-10

The clinical significance of small intestinal fungal overgrowth lies in its potential to cause chronic gastrointestinal symptoms and nutritional deficiencies, impacting patient quality of life. Understanding SIFO is crucial for population health, as it may be underdiagnosed and mismanaged, leading to increased healthcare utilization. Epidemiologically, the condition may be more prevalent in immunocompromised populations, necessitating awareness and appropriate management strategies to improve health outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is well-supported by clinical evidence, as payers may deny claims lacking sufficient documentation. Common denials may arise from insufficient detail in the medical record or failure to demonstrate the medical necessity of the tests performed. Best practices include maintaining clear and concise documentation of symptoms, diagnostic tests, and treatment plans to support the coding and billing process effectively.

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 K63.822?

K63.822 specifically covers small intestinal fungal overgrowth, primarily involving Candida species. It is important to note that this code does not cover other gastrointestinal fungal infections or conditions related to bacterial overgrowth.

When should K63.822 be used instead of related codes?

K63.822 should be used when there is clear evidence of fungal overgrowth in the small intestine, as confirmed by clinical symptoms and diagnostic testing. It is crucial to differentiate it from K63.821, which pertains to bacterial overgrowth.

What documentation supports K63.822?

Documentation for K63.822 should include clinical symptoms, results from diagnostic tests (such as stool cultures or endoscopic findings), and any relevant medical history that supports the diagnosis of small intestinal fungal overgrowth.