Coding Insight – Postoperative Ileus

Postoperative Ileus

Coding Clinic, 1st Quarter 2017: Page 40

Effective with discharges March 13, 2017

  • Since an ileus can either be obstructive or non-obstructive, Coding Clinic advises that coders cannot assume that a postoperative ileus is obstructive
  • To assign the correct ICD-10 code, documentation must be clear as to whether the ileus is related or unrelated to surgery and if it is obstructive (mechanical) or non-obstructive (paralytic)
  • Paralytic (non-obstructive or pseudo-obstruction) causes include: abdominal surgery, decreased blood supply to the intestines, and infections such as appendicitis
  • Mechanical (obstructive) causes include: adhesions, hernias, and impacted stools
  • Coding Clinic recommends the following ICD-10 codes for documentation of:
    • Ileus due to surgery (non-obstructive)
      • K91.89 (Other postprocedural complications and disorders of digestive system)
      • K56.7 (Ileus, unspecified)
    • Ileus due to surgery (obstructive)
      • K91.3 (Postprocedural intestinal obstruction)
    • Ileus unrelated to surgery (non-obstructive)
      • K56.7 (Ileus, unspecified)
    • Ileus unrelated to surgery (obstructive)
      • K56.69 (Other intestinal obstruction)
  • If documentation is unclear, Coding Clinic recommendations that a query is sent to the provider

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