Q&A: Coding Congenital Conditions in Adults
Published on
Wednesday, March 6, 2024
Question
What if a provider documents arteriovenous malformation (AVM) of the stomach and the patient is 87 years old? How should this be coded?
Answer
Sometimes, a provider documents a condition, and the ICD-10-CM Alphabetic Index leads the coder to assign a congenital condition. In this case, it’s AVM of the stomach.
Anomaly
Arteriovenous NEC
Gastrointestinal Q27.33
Since the patient is older, look for documentation that states the condition is congenital, inherited, or the patient has had the condition since birth, or other similar terms. If there is no documentation of the condition being congenital, query the provider for clarification. If he/she documents that the condition developed later in life, refer to the term ‘acquired’ in the index and follow the instruction. Acquired AVM of the stomach is coded to angiodysplasia of stomach and duodenum without bleeding (K31.819).
Anomaly
Arteriovenous NEC
Gastrointestinal Q27.33
Acquired – see Angiodysplasia
Angiodysplasia
Stomach (and duodenum) K31.819
References
ICD-10-CM Alphabetic Index
ICD-10-CM Official Coding Guidelines
Article Author: Susie James, RHIT, CCS
Susie James, RHIT, CCS, is the Manager of Inpatient Coding Services at MMP, Inc. Susie has worked in the coding field for over 30 years and has worked as a coder, coding supervisor, and corporate coding manager for a large multi-facility system in Birmingham. She also worked for Alabama Quality Assurance Foundation (AQAF) as a coding reviewer/auditor before joining the team at Medical Management Plus, Inc. Susie has previously served as the President of the Alabama Association of Health Information Management (AAHIM) on the Board of Directors and currently serves as the Education/Coding Roundtable Chair. She is also a member of the American Health Information Management Association (AHIMA) and has previously served as the Co-chair for AHIMA's Leadership Team. She also served as a facilitator at AHIMA's 85th National Convention in Atlanta Georgia.
