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2025 ICD-10-CM code K82.A1

Gangrene of gallbladder in cholecystitis.

When coding K82.A1, it's crucial to code first the underlying cholecystitis (K81.-) or cholelithiasis with cholecystitis (K80.00-K80.19, K80.40-K80.47, K80.60-K80.67).Conditions such as nonvisualization of the gallbladder (R93.2) and postcholecystectomy syndrome (K91.5) are excluded from this code.

Medical necessity for services related to K82.A1 stems from the potentially life-threatening nature of gangrenous cholecystitis. Prompt diagnosis and treatment, usually involving surgical removal of the gallbladder, are essential to prevent serious complications such as perforation, peritonitis, and sepsis.

Clinicians responsible for diagnosing and managing K82.A1 typically include emergency medicine physicians, general surgeons, gastroenterologists, and critical care specialists. Their responsibilities encompass confirming the diagnosis through imaging studies (ultrasound, CT scans), stabilizing the patient's condition (managing sepsis, pain, and fluid balance), and performing or consulting on the necessary surgical intervention (cholecystectomy). Post-operative care, including monitoring for complications and ensuring appropriate antibiotic therapy, also falls under their purview.

In simple words: This code indicates that a patient has tissue death in their gallbladder due to inflammation.

This code signifies the presence of gangrene (tissue death) in the gallbladder specifically occurring during an episode of cholecystitis (inflammation of the gallbladder). It indicates a severe and potentially life-threatening complication requiring prompt medical attention.

Example 1: A 70-year-old diabetic patient presents with severe right upper quadrant pain, fever, and signs of sepsis. Imaging reveals a distended gallbladder with gas in the wall, indicative of gangrenous cholecystitis., A 55-year-old female with a history of gallstones experiences worsening abdominal pain, vomiting, and low blood pressure. A CT scan shows an inflamed gallbladder with areas of non-perfusion, suggestive of gangrene., An 80-year-old male with a history of acute cholecystitis develops sudden, severe abdominal pain and a palpable mass. Imaging studies and subsequent surgery confirm gangrenous cholecystitis with perforation.

Documentation for K82.A1 should include detailed clinical findings (e.g., abdominal pain, fever, nausea, vomiting, tenderness), laboratory results (e.g., elevated white blood cell count, abnormal liver function tests), and imaging findings (e.g., gallbladder wall thickening, pericholecystic fluid, gas in the gallbladder wall or lumen) supporting the diagnosis. Operative reports should confirm the presence of gangrene upon direct visualization of the gallbladder.

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