ICD-10-CM 2018: Focus on Partial and Complete for Intestinal Obstruction Coding Updates

Mon, Sep 11, 2017 --

Coding Updates, ICD-10

Intestinal obstruction coding changes are coming October 1 with ICD-10-CM 2018, meaning you need to be sure your documentation can stand up to new requirements. Here are some tips from General Surgery Coder to help you on your way.

But first: For those of you with patients affected by recent hurricanes, the CDC has posted “ICD-10-CM Coding Advice for Healthcare Encounters in Hurricane Aftermath” on its ICD-10-CM page.

Add Fifth Character to Codes for Intestinal Adhesions With Obstruction

Under ICD-10-CM 2017, you have K56.5 (Intestinal adhesions [bands] with obstruction (postprocedural) (postinfection)). The code is complete and reportable with four characters.

ICD-10-CM 2018, however, says four characters are not enough! You’ll need five characters to form a reportable code:

  • K56.5- (Intestinal adhesions [bands], with obstruction (postinfection))
  • K56.50 (Intestinal adhesions [bands], unspecified as to partial versus complete obstruction)
  • K56.51 (… with partial obstruction)
  • K56.K91.52 (… with complete obstruction).

What’s different: There are two major changes to know.

First, note the separation into codes for unspecified, partial, and complete obstruction. Documentation needs to specify partial or complete to help you choose the most appropriate code.

Second, ICD-10 removes the term “postprocedural” from K56.5-. Read the next section for more on how to code for postprocedural diagnoses.

Expand Postprocedural Options

ICD-10-CM 2017 includes K91.3 (Postprocedural intestinal obstruction).

ICD-10-CM 2018 adds a requirement for one more character to complete the code:

  • K91.30 (Postprocedural intestinal obstruction, unspecified as to partial versus complete)
  • K91.31 (Postprocedural partial intestinal obstruction)
  • K91.32 (Postprocedural complete intestinal obstruction).

Again, partial and complete are the terms to watch.

Pick 6 for Other and Unspecified

The updates to emphasize partial and complete also affect subcategory K56.6- (Other and unspecified intestinal obstruction). Current options K56.60 (Unspecified intestinal obstruction) and K56.69 (Other intestinal obstruction) will require sixth characters to be complete:

  • K56.600 (Partial intestinal obstruction, unspecified as to cause)
  • K56.601 (Complete intestinal obstruction, unspecified as to cause)
  • K56.609 (Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction)
  • K56.690 (Other partial intestinal obstruction)
  • K56.691 (Other complete intestinal obstruction)
  • K56.699 (Other intestinal obstruction unspecified as to partial versus complete obstruction).

Nab the Right NOS or NEC Option

The addition of new codes often results in changes to notes and index entries, too, so be sure to check for revisions and update any job aids accordingly. Here are some tips to get you started:

  • For intestinal adhesions with obstruction NOS, use K56.50
  • For incomplete intestinal obstruction NOS, use K56.600
  • For intestinal obstruction NOS, use K56.609
  • For other intestinal obstruction NEC, use K56.699
  • For postprocedural intestinal obstruction NOS, use K91.30.

What About You?

Does your documentation currently specify partial or complete, or will you need to add this change to your training plan?

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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