Before & After: 3 Ways Your GI ICD-10 Coding Will Change Oct. 1

Tue, Aug 2, 2016 --


gastroenterology ICD10 2017

During the ICD-10 transition, two characteristics that got a lot of attention were ICD-10’s detailed codes and the new code set’s room for expansion. The ICD-10 2017 updates released by the CDC and CMS reveal that the two characteristics go hand in hand: more room to expand means more room to add specificity requirements.

Here’s how that change will play out for gastroenterology ICD-10 coders when the 2017 codes become effective for dates of service Oct. 1, 2016, and later.

1. Move Stromal Tumor Search to C49.A-

Before: In ICD-10-CM 2016, the Index entry for Tumor, Stromal, Gastrointestinal, Malignant points you to C49.4 (Malignant neoplasm of connective and soft tissue of abdomen). The Stomach entry points you to C16.9 (Malignant neoplasm of stomach, unspecified).

After: Starting with Oct. 1 DOS, you’ll have more specific options for malignant stromal GI tumors based on site:

  • C49.A0, Gastrointestinal stromal tumor, unspecified site
  • C49.A1, … esophagus
  • C49.A2, … stomach
  • C49.A3, … small intestine
  • C49.A4, … large intestine
  • C49.A5, … rectum
  • C49.A9, … other sites.

2. Include These IBS Additions in CDI Training

Before: You’re no doubt familiar with ICD-10 2016’s options for IBS:

  • K58.0, Irritable bowel syndrome with diarrhea
  • K58.9, Irritable bowel syndrome without diarrhea.

After: ICD-10 2017 keeps K58.0 and K58.9, but it also will add three new options:

  • K58.1, Irritable bowel syndrome with constipation
  • K58.2, Mixed irritable bowel syndrome
  • K58.8, Other irritable bowel syndrome.

Tip: Coders in the field report that documentation in the real-world may offer no more details than “IBS.” Be sure to share the new codes with providers so they know the sort of detail ICD-10 includes. But if the medical records you see continue to state only IBS, keep in mind that in both the 2016 and 2017 ICD-10 code sets, K58.9 is appropriate for IBS NOS.

3. Know Necrosis and Infection Status for Pancreatitis

Before: ICD-10 2016 gives you six codes to choose from for acute pancreatitis in the range K85.0-K85.9.

After: ICD-10 2017 multiples your choices by three. Each of the existing four-character 2016 ICD-10 pancreatitis codes will require a fifth character under ICD-10 2017:

  • 0, … without necrosis or infection
  • 1., …with uninfected necrosis
  • 2, … with infected necrosis.

How About You?

How is your practice preparing for gastroenterology ICD-10-CM changes for 2017? Are you following the same process that you used for ICD-9 updates or does ICD-10 require a different approach?


Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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