Hemorrhoids ICD-10-CM Codes

What ICD-10 codes are used for hemorrhoids?

The diagnosis and billing for hemorrhoids require the correct ICD 10 CM codes for accuracy. Properly coding hemorrhoids, perianal venous thrombosis, and related conditions helps healthcare providers align with insurance and documentation standards. Below are the most widely used hemorrhoid ICD codes for different types and severities:

• K64.0: First degree hemorrhoids: This code describes a patient with first degree hemorrhoids, which are minor swollen veins located inside the lining of the anal canal. These hemorrhoids are not visibly protruding and usually exhibit minimal symptoms like light bleeding during a bowel movement.
• K64.1: Second degree hemorrhoids: This code pertains to second degree hemorrhoids that may protrude outside the anus, especially during or after a bowel movement. These hemorrhoids often require manual retraction and can be associated with discomfort, itching, and pain.
• K64.2: Third degree hemorrhoids: This code relates to third degree hemorrhoids, where the hemorrhoidal tissue protrudes permanently and must be manually pushed back inside the lower rectum. Third degree hemorrhoids often bleed and worsen without treatment.
• K64.3: Fourth degree hemorrhoids: This code is used for fourth degree hemorrhoids, which are enlarged, protruding, and remain outside the anus without the ability to be pushed back in. They may also involve residual hemorrhoidal skin tags.
• K64.8: Other hemorrhoids: This code captures other diseases related to hemorrhoidsnot categorized under the typical degrees mentioned above.
• K64.9: unspecified hemorrhoids: Unspecified hemorrhoids are coded here when the type (internal or external) or the severity (first, second, third, or fourth degree) isn't documented. It also applies to cases noted as hemorrhoids bleeding NOS (not otherwise specified).

Which hemorrhoids ICD codes are billable?

Every hemorrhoid code listed is billable under ICD 10 CM standards, provided documentation supports it:

• K64.0: Billable for first degree hemorrhoids diagnosis.
• K64.1: Billable for second degree hemorrhoids with prolapse after bowel movement.
• K64.2: Billable for third degree hemorrhoids requiring manual reduction.
• K64.3: Billable for fourth degree hemorrhoids that are constantly external.
• K64.8: Billable for other hemorrhoids and perianal venous thrombosis cases.
• K64.9: Billable for unspecified hemorrhoids with or without bleeding.

Coding must specify if the case involves hemorrhoids complicating pregnancy, hemorrhoids complicating childbirth, or if it occurs during childbirth and puerperium periods, using additional pregnancy-related codes when needed.

Clinical information

Hemorrhoids involve swollen veins in the lower part of the rectum and anus. Here's what you need to know:

Signs and symptoms

• Hemorrhoids can exhibit symptoms such as itching, pain, irritation, and bleeding without mention of degree during a bowel movement.
• In severe cases, patients may experience protruding, enlarged, or external hemorrhoids with noticeable discomfort.
• Internal hemorrhoids may be less painful but can still cause bleeding or lead to complications like residual hemorrhoidal skin tags.

Risk factors

• Straining during bowel movements, pregnancy, prolonged sitting, obesity, and a low-fiber diet increase pressure in the digestive system, especially in the lower rectum, leading to hemorrhoids.
• Hemorrhoids and perianal venous thrombosis often share similar risk profiles.

Diagnosis

• A physical examination of the anus, anal canal, and rectum is often sufficient.
• In some cases, anoscopy or sigmoidoscopy is used to visualize internal hemorrhoids and rule out other diseases.

Treatment

• Treatments include lifestyle adjustments like a high-fiber diet, stool softeners, and plenty of hydration.
• In more severe cases of third-degree or fourth-degree hemorrhoids, medical procedures such as rubber band ligation, sclerotherapy, or hemorrhoidectomy may be necessary.
• Perianal venous thrombosis can sometimes be managed conservatively but may require surgical intervention if severe.

Prevention

• Consuming fiber-rich foods, avoiding prolonged sitting, staying active, drinking adequate fluids, and practicing proper toilet habits can reduce the risk of developing hemorrhoids or related diseases.

Important notes

• Always mention the degree of hemorrhoids when coding and billing, unless explicitly categorized under hemorrhoids bleeding without mention of degree or nos hemorrhoids.
• Use appropriate code selection to ensure accurate medical billing and efficient treatment planning.

Synonyms include

• Piles
• Rectal swelling
• Rectal lumps
• Anal hemorrhoids
• Hemorrhoidal disease