Enlight-10-ment: August

August 19, 2015

Digestion of Digestive Codes

The digestive system is made up of the gastrointestinal tract. Digestion begins in the mouth with chewing the food, and ends in the small intestine; its unique function is to breakdown and process the food we eat, while removing unused products for waste disposal. The body then absorbs these smaller particles through the walls of the small intestine into the bloodstream, which delivers them to the rest of the body in form of nutrients and energy. This is essential to maintain good health.

Digestion is a form of catabolism that is often divided into two processes based on how food is broken down: mechanical and chemical digestion. The term mechanical digestion refers to the physical breakdown of large pieces of food into smaller pieces which can subsequently be accessed by digestive enzymes. In chemical digestion, enzymes break down food into the small molecules the body can use.

The digestive system is composed of the following organs:

  • Oral cavity
  • The esophagus
  • The stomach
  • The small and large intestines

The liver, gallbladder, and exocrine pancreas are accessory organs of the digestive system; their function is to produce secretions that
break down the food.

The alphanumeric codes for diseases of the digestive system in the ICD-10 are in chapter 11: Diseases of the Digestive System (K00-K95), these codes starts with letter K. If it helps, you can think of digesting Special K!

The wording has not changed for many conditions in this chapter, only the code for certain conditions such as ulcers (gastric, duodenal, peptic, and gastrojejunal), also gastritis and duodenitis are no longer classified with or without mention of obstruction, but these codes in the tabular index have a “Use additional code:” note to identify if applicable the exposure, history, use or dependence of smoking or tobacco and/or alcohol.

Use additional codes, where applicable, to identify:

Alcohol abuse and dependence (F10.-)

Exposure to environmental tobacco smoke (Z77.22)

Exposure to tobacco smoke in the perinatal period (P96.81)

History of tobacco use (Z87.891)

Occupational exposure to environmental tobacco smoke (Z57.31)

Tobacco dependence (F17.-)

Tobacco use (Z72.0)

Documentation

In the ICD-10 certain category codes require specific documentation:

“Noninfective enteritis and colitis” (K50-K52)

Crohn’s Disease must be documented as with or without complications and the complications must be specifically documented as rectal bleeding (K05.011), intestinal obstruction (K50. 012), fistula (K50.013), abscess (K50.014), other (K50.018), and unspecified (K50.019)

“Other diseases of intestines” (K55-K64)

Diverticulosis, and diverticulitis of the small intestine, and Diverticulosis and diverticulitis of the colon must be documented as with or without perforation of abscess as well as with or without bleeding.

Example 1: K57.00 Diverticulitis of small intestine with perforation and abscess without bleeding.

Example 2: K57.30 Diverticulosis of large intestine without perforation or abscess without bleeding.

Guidelines

ICD-10-CM reserved this section for future guideline expansion.

Conclusion

The changes to this chapter are not overwhelming; however, documentation of these conditions will have to be addressed. Consider yourself enlight-10’d.

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