This article lists the symptoms, treatment and medical codes for gallstones, a condition wherein stone-like objects form in the gallbladder or bile ducts.

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Medical Codes for Gallstones
– A Common Condition of the
Gallbladder
This article lists the symptoms, treatment and
medical codes for gallstones, a condition
wherein stone-like objects form in the
gallbladder or bile ducts.
Outsource Strategies International
United States

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Gallstones are hardened deposits of digestive fluid - usually made of
cholesterol or bilirubin - that form in the gallbladder or bile duct. The
gallbladder holds a digestive fluid called “bile” that's released into the small
intestine. Also known as cholecystitis, these stones can form when there is a
chemical imbalance in the gallbladder. These can be tiny (the size of a grain
of sand), or as large as a golf ball. In certain cases, patients may develop
just one gallstone, while in other cases patients may develop many
gallstones at the same time. Typically, gallstones don’t cause any specific
signs and symptoms and don’t need any treatment. However, if a gallstone
becomes trapped in an opening (duct) inside the gallbladder, it can trigger
sudden intense abdominal pain (known as biliary colic). Treatment for this
condition usually involves medications (to dissolve gallstones) and in more
complex cases gallbladder removal surgery (cholecystectomy). Medical
billing and coding for this condition can be complex as it requires correct
understanding of the rules related to the usage of codes and modifiers and
payer specific guidelines. Partnering with a reliable gastroenterology
medical billing company that has expert coders and billing specialists on
board is a perfect strategy for providers to report and bill for this condition
correctly.
According to Medscape.com, about 20 million people in the United States
have gallstones. Every year, in the United States, approximately 500,000
people develop symptoms or complications of gallstones requiring
cholecystectomy. The exact causes of this condition are not known.
However, experts opine that the condition occurs when your bile contains
too much cholesterol or bilirubin and when your gallbladder doesn't empty
correctly. Several factors may increase the risk of this condition such as –
female gender, age, being overweight or obese, eating a diet that’s high in
fat or cholesterol or low in fiber, having cirrhosis or taking medications that
have high estrogen content. If left untreated, this condition can lead to

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several complications like inflammation of the gallbladder, blockage of the
common bile duct/pancreatic duct and gallbladder cancer.
Types of Gallstones
Generally, stones in the gallbladder may form when cholesterol, calcium
bilirubinate, and calcium carbonate in the bladder are out of balance. There
are two main types of gallstones -
 Cholesterol gallstones – These stones form if there is too much
cholesterol in the bile.
 Pigment gallstones – A common problem among people with liver
disease, infected bile tubes, or blood disorders. These form when the
bile has too much bilirubin.
Common Symptoms
In most cases, this condition may not cause any specific signs and
symptoms. This may be because the stones may stay in the gallbladder and
cause no problems. However, if a gallstone lodges in a duct and causes a
blockage, certain symptoms appear. One of the primary symptoms
associated with the condition is pain that comes on suddenly and quickly
gets worse. Other related symptoms include -
 Stomach pain
 Pain on the right-hand side of the body, just below the ribs
 Back pain between the shoulder blades
 Nausea or vomiting
 Sweating
 Restlessness
 Dark urine
 Burping
 Indigestion

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The pain may last for several minutes to a few hours.
How Are Gallstones Diagnosed and Treated?
Diagnosis of this condition may generally begin with detailed discussion
between the patient and physician. The physician may ask general questions
about the typical symptoms patients experience. A wide range of diagnostic
imaging tests such as ultrasound and a computerized tomography (CT) scan
will be performed to create images of the gallbladder and to look for possible
symptoms related to this condition.
Tests to check bile ducts for cholecystitis will also be conducted as part of
the diagnosis. These tests use a special dye to highlight the bile ducts on
images and determine whether a gallstone is causing a blockage. These
tests include hepatobiliary iminodiacetic acid (HIDA) scan, magnetic
resonance imaging (MRI) and endoscopic retrograde
cholangiopancreatography (ERCP). Blood tests to check for any possible
complications like infection, jaundice, pancreatitis or other complications
caused by gallstones will also be done.
Most people with gallstones that don't cause symptoms will never need
treatment. However, gastroenterologists will determine whether the patient
needs treatment based on his/her symptoms and the results of diagnostic
testing. Treatment is usually only necessary if cholecystitis is causing
symptoms, such as abdominal pain and other complications like jaundice or
acute pancreatitis. In such cases, keyhole surgery to remove the gallbladder
may be recommended. This procedure, known as a laparoscopic
cholecystectomy, generally involves only a low risk of complications. In
addition, medications to dissolve gallstones will generally be recommended
for patients who cannot undergo surgery.

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Gastroenterology medical coding involves using the specific ICD-10 and
CPT codes for reporting gallstones on the medical claims providers submit to
health insurers for reimbursement.
ICD-10 Codes to indicate a diagnosis of “Gallstones/ Cholecystitis”
 K80 - Cholelithiasis
 K80.0 - Calculus of gallbladder with acute cholecystitis
 K80.00 - Calculus of gallbladder with acute cholecystitis,
without obstruction
 K80.01 - Calculus of gallbladder with acute cholecystitis, with
obstruction
 K80.1 - Calculus of gallbladder with other cholecystitis
 K80.10 - Calculus of gallbladder with chronic cholecystitis
without obstruction
 K80.11 - Calculus of gallbladder with chronic cholecystitis with
obstruction
 K80.12 - Calculus of gallbladder with acute and chronic
cholecystitis without obstruction
 K80.13 - Calculus of gallbladder with acute and chronic
cholecystitis with obstruction
 K80.18 - Calculus of gallbladder with other cholecystitis, without
obstruction
 K80.19 - Calculus of gallbladder with other cholecystitis, with
obstruction
 K80.2 - Calculus of gallbladder without cholecystitis
 K80.20 - Calculus of gallbladder without cholecystitis, without
obstruction
 K80.21 - Calculus of gallbladder without cholecystitis, with
obstruction
 K80.3 - Calculus of bile duct with cholangitis

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 K80.30 - Calculus of bile duct with cholangitis, unspecified,
without obstruction
 K80.31 - Calculus of bile duct with cholangitis, unspecified, with
obstruction
 K80.32 - Calculus of bile duct with acute cholangitis without
obstruction
 K80.33 - Calculus of bile duct with acute cholangitis with
obstruction
 K80.34 - Calculus of bile duct with chronic cholangitis without
obstruction
 K80.35 - Calculus of bile duct with chronic cholangitis with
obstruction
 K80.36 - Calculus of bile duct with acute and chronic cholangitis
without obstruction
 K80.37 - Calculus of bile duct with acute and chronic cholangitis
with obstruction
 K80.4 - Calculus of bile duct with cholecystitis
 K80.40 - Calculus of bile duct with cholecystitis, unspecified,
without obstruction
 K80.41 - Calculus of bile duct with cholecystitis, unspecified,
with obstruction
 K80.42 - Calculus of bile duct with acute cholecystitis without
obstruction
 K80.43 - Calculus of bile duct with acute cholecystitis with
obstruction
 K80.44 - Calculus of bile duct with chronic cholecystitis without
obstruction
 K80.45 - Calculus of bile duct with chronic cholecystitis with
obstruction

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 K80.46 - Calculus of bile duct with acute and chronic
cholecystitis without obstruction
 K80.47 - Calculus of bile duct with acute and chronic
cholecystitis with obstruction
 K80.5 - Calculus of bile duct without cholangitis or cholecystitis
 K80.50 - Calculus of bile duct without cholangitis or cholecystitis,
without obstruction
 K80.51 - Calculus of bile duct without cholangitis or cholecystitis,
with obstruction
 K80.6 - Calculus of gallbladder and bile duct with cholecystitis
 K80.60 - Calculus of gallbladder and bile duct with cholecystitis,
unspecified, without obstruction
 K80.61 - Calculus of gallbladder and bile duct with cholecystitis,
unspecified, with obstruction
 K80.62 - Calculus of gallbladder and bile duct with acute
cholecystitis without obstruction
 K80.63 - Calculus of gallbladder and bile duct with acute
cholecystitis with obstruction
 K80.64 - Calculus of gallbladder and bile duct with chronic
cholecystitis without obstruction
 K80.65 - Calculus of gallbladder and bile duct with chronic
cholecystitis with obstruction
 K80.66 - Calculus of gallbladder and bile duct with acute and
chronic cholecystitis without obstruction
 K80.67 - Calculus of gallbladder and bile duct with acute and
chronic cholecystitis with obstruction
 K80.7 - Calculus of gallbladder and bile duct without
cholecystitis

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 K80.70 - Calculus of gallbladder and bile duct without
cholecystitis, without obstruction
 K80.71 - Calculus of gallbladder and bile duct without
cholecystitis, with obstruction
 K80.8 - Other cholelithiasis
 K80.80 - Other cholelithiasis, without obstruction
 K80.81 - Other cholelithiasis, with obstruction
 K81 - Cholecystitis
 K81.0 - Acute cholecystitis
 K81.1 - Chronic cholecystitis
 K81.2 - Acute cholecystitis with chronic cholecystitis
 K81.9 - Cholecystitis, unspecified
CPT Codes for Cholecystectomy – Removal of the Gallbladder
 47562 - Laparoscopic cholecystectomy without cholangiography
 47563 - Laparoscopic cholecystectomy with cholangiography
 47564 - Laparoscopic cholecystectomy with exploration of the common
bile duct
 47600 - Cholecystectomy without cholangiography
 47605 - Cholecystectomy with cholangiography
 47610 - Cholecystectomy with exploration of the common bile duct
Incorporating a combination of healthy lifestyle changes and medications
can help control the formation of gallbladder stones. Common preventive
measures include maintaining a healthy body weight, eating more fruits and
vegetables, stopping the habit of skipping meals and losing body weight
slowly.
Treating physicians need to maintain accurate medical documentation of
cholecystitis. Partnering with a reliable and experienced medical billing
company can ensure accurate reporting of gastroenterology diagnosis and

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procedures. Reputable companies will have experienced AAPC-certified
coders on board who have adequate knowledge about billing and coding
guidelines related to this medical specialty and can ensure accurate claims
for optimal reimbursement.