Chapter XI - Diseases of the digestive system

Question 1

If constipation is mentioned with a diagnosis of ileus and bowel obstruction how should this be coded?

Answer 1

Constipation must not be coded - it is an integral part of a diagnosis of ileus and bowel obstruction.

Question 2

Explain how Barrett oesophagus with low or high grade dysplasia should be coded?

Answer 2

Barrett oesophagus should always be coded to K22.7 Barrett oesophagus whether mentioned with or without low or high grade dysplasis. Always coded to K22.7.

Question 3

How is peptic ulcer disease (K25-K28) classified?

Answer 3

Peptic ulcers are classified by site.

Question 4

When can the code K27.- Peptic ulcer be used?

Answer 4

Only when information about the site of the peptic ulcer is not available. If the site is documented, this must be coded to an ulcer of the stated site.

Question 5

How must hernias with both gangrene and obstruction be coded?

Answer 5

Hernias with both gangrene and obstruction should be classified to hernia with gangrene.

Question 6

How should a diagnosis of diarrhoea, not specified as either infectious or non-infectious be coded?

Answer 6

A09.- Other gastroenteritis and colitis of infectious and unspecified origin.

Question 7

When can the code K29.9 Gastroduodenitis, unspecified be coded?

Answer 7

Only when it is specified that the patient has both K29.7 Gastritis, unspecified and K29.8 Duodenitis.
If a specific type of gastritis is documented, the code for th specific type should be assigned together with K29.8 Duodenitis.

Question 8

How must Helicobacter pylori associated gastritis be coded?

Answer 8

1. K29.6 Other gastritis (if a specific type of gastritis is stated, code to that instead)
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2. B98.0 Helicobacter pylori as the cause if diseases classified to other chapters

Question 9

How should H. Pylori that is not the cause of another disease be coded?

Answer 9

A04.8 Other specified bacterial intestinal infections

Question 10

How should parastomal hernias be coded?

Answer 10

Z93.- Artificial opening status must be assigned in addition to a code from K43.3-K43.5 to show the type of stoma.

Question 11

When can the code K52.3 Indeterminate colitis be assigned?

Answer 11

Must only be assigned when so stated by the responsible consultant.

Question 12

A diagnosis of indeterminate colitis may be made when the consultant is unable to differentiate between which two types of IBD?

Answer 12

Ulcerative colitis and Crohns disease

Question 13

Explain the difference between codes:
* K62.5 Haemorrhage of anus and rectum
and
* K92.2 Gastrointestinal haemorrhage, unspecified
and how should wach be used.

Answer 13

• K62.5 Haemorrhage of anus and rectum must only be assigned for an actual haemorrhage of the anus and/or rectum. (Must not be assigned for a haemorrhage that has occured from elsewhere and is merely exiting from the rectum)
• K92.2 Gastrointestinal haemorrhage, unspecified must be assigned for a haemorrhage that occured via the rectum but is not specified as being from the actual rectum/anus. Must not be assigned when it is a symptom of a disease which has been diagnosed.

Question 14

How must haemorroids be coded when there is more than one degree/stage/grade documented?

Answer 14

Code only to the highest degree, stage or grade.

Question 15

How should alcoholic liver disease or alcohol-induced pancreatitis due to current dependence or misuse of alcohol be coded?

Answer 15

1. Code for the Alcoholic liver disease (K70.-) or Alcohol-induced pancreatitis (K85.2 or K86.0)
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2. Code for dependence/misuse of alcohol (F10.1/F10.2)

Question 16

How should alcoholic liver disease or alcohol-induced pancreatitis due to previous alcohol abuse be coded?

Answer 16

1. Code for the Alcoholic liver disease (K70.-) or Alcohol-induced pancreatitis (K85.2 or K86.0)
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2. Z86.4 Personal history of psychoactive substance abuse