2025 ICD-10-CM code K31.6
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Digestive System Diseases - Diseases of esophagus, stomach and duodenum Diseases of the digestive system Feed
Fistula of stomach and duodenum.
Modifiers are not applicable to ICD-10-CM codes.
Medical necessity for treatment of K31.6 is established by the presence of symptoms (e.g., pain, bleeding, infection, malnutrition), the risk of complications (e.g., peritonitis, sepsis), and the need for definitive management (e.g., surgery, endoscopic treatment).
The clinical responsibility for a patient with K31.6 involves diagnosis through imaging studies (such as endoscopy or CT scan), assessment of the fistula's extent and complications, and management of the condition, potentially involving surgical or non-surgical interventions.
In simple words: This code describes an abnormal connection (fistula) between the stomach and the duodenum (the first part of the small intestine). This connection can also involve other parts of the digestive system, such as the colon.It is a serious condition that needs medical attention.
K31.6 in the ICD-10-CM classification denotes a fistula of the stomach and duodenum.This refers to an abnormal connection between the stomach and duodenum, or between these organs and another structure such as the colon (gastrocolic fistula) or jejunum (gastrojejunocolic fistula).The condition can result from various causes including trauma, surgery, inflammation, or malignancy.
Example 1: A patient presents post-surgery with abdominal pain and evidence of a connection between their stomach and colon, diagnosed as a gastrocolic fistula (K31.6)., A patient with a history of Crohn's disease develops a fistula between their stomach and duodenum, necessitating surgical repair (K31.6)., A patient sustains a penetrating abdominal injury that results in a fistula between their stomach and duodenum, requiring emergency surgery and intensive care (K31.6).
Documentation should include the history of the condition (trauma, surgery, inflammatory bowel disease, etc.), findings from imaging studies (endoscopy, CT, etc.), details about the fistula's location and extent, management of the condition, and clinical course.
** Differential diagnosis is critical to distinguish K31.6 from other gastrointestinal conditions.Accurate coding requires thorough review of clinical documentation.
- Revenue Code: Revenue codes will vary depending on the specific services provided and the healthcare setting.Further information is needed to determine the appropriate revenue codes.
- RVU: RVUs are not applicable to ICD-10 codes.RVUs are associated with CPT codes, which represent procedures and services.
- Global Days: Not applicable to this ICD-10 code.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Fee Schedule: Not applicable to ICD-10-CM codes. Fee schedules relate to procedural codes such as CPT and HCPCS.
- Specialties:Gastroenterology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center