Understanding Chronic Cholecystitis with Cholelithiasis: This resource provides information on chronic gallbladder inflammation with gallstones, including symptoms, diagnosis, treatment, and medical coding for chronic calculous cholecystitis. Learn about clinical documentation best practices for C Chronic Cholecystitis with Cholelithiasis and related healthcare considerations.
Also known as
Diseases of the gallbladder, biliary tract
Covers gallbladder and bile duct disorders including inflammation and stones.
Cholelithiasis
Specifically relates to the presence of gallstones in the gallbladder.
Cholecystitis
Covers inflammation of the gallbladder, both acute and chronic forms.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the cholecystitis chronic AND with cholelithiasis?
Yes
Any evidence of acute exacerbation?
No
Is it chronic cholecystitis without calculi?
When to use each related code
| Description |
|---|
| Chronic gallbladder inflammation with gallstones. |
| Acute cholecystitis with gallstones. |
| Biliary colic without cholecystitis. |
Coding chronic cholecystitis without specifying acute exacerbations or quiescent state can lead to undercoding or overcoding.
Failing to document and code associated common bile duct stones (choledocholithiasis) if present impacts reimbursement and care.
Imprecise documentation of gallstone type (cholesterol, pigment) can affect coding accuracy and statistical reporting.
Q: What are the best diagnostic imaging modalities for differentiating chronic cholecystitis with cholelithiasis from other biliary pathologies like gallbladder polyps or adenomyomatosis in symptomatic patients?
A: While ultrasound remains the initial imaging modality for suspected chronic cholecystitis with cholelithiasis, differentiating it from other biliary pathologies like gallbladder polyps or adenomyomatosis can sometimes be challenging. For complex cases or when ultrasound findings are equivocal, further evaluation with magnetic resonance cholangiopancreatography (MRCP) or endoscopic ultrasound (EUS) can be beneficial. MRCP provides detailed anatomical visualization of the biliary tree and can help identify subtle abnormalities, while EUS offers high-resolution imaging and the possibility of tissue sampling if needed. Consider implementing a multi-modal imaging approach for challenging diagnoses, particularly when surgical intervention is being considered. Explore how incorporating MRCP and EUS into your diagnostic algorithm can improve diagnostic accuracy in complex biliary cases.
Q: How do I manage a patient with chronic cholecystitis with cholelithiasis who is medically unfit for cholecystectomy due to significant comorbidities?
A: Managing chronic cholecystitis with cholelithiasis in patients who are medically unfit for surgery due to significant comorbidities requires a careful and individualized approach. Non-surgical management options include pain management with analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs), dietary modifications (low-fat diet), and control of underlying medical conditions. For patients experiencing recurrent biliary colic despite conservative measures, percutaneous cholecystostomy tube placement can provide temporary or long-term relief of biliary obstruction and symptom control. Learn more about the role of interventional radiology in managing chronic cholecystitis in high-risk surgical patients. Explore how a multidisciplinary approach involving gastroenterologists, surgeons, and interventional radiologists can optimize outcomes for this complex patient population.
Patient presents with a history of recurrent biliary colic, characterized by episodic right upper quadrant pain, often postprandial, especially after fatty meals. The patient reports the pain may radiate to the right shoulder or back and is sometimes accompanied by nausea and vomiting. Physical examination reveals tenderness in the right upper quadrant upon palpation, possible Murphy's sign elicited. Ultrasound imaging of the gallbladder demonstrates cholelithiasis, with multiple echogenic foci demonstrating acoustic shadowing, consistent with gallstones. Findings suggestive of chronic cholecystitis include gallbladder wall thickening and pericholecystic fluid. Differential diagnoses considered include biliary dyskinesia, peptic ulcer disease, and pancreatitis. The patient's symptoms, coupled with the imaging findings, support a diagnosis of chronic cholecystitis with cholelithiasis. Treatment options, including laparoscopic cholecystectomy, were discussed with the patient. Risks and benefits of surgical and non-surgical management were explained. The patient will be scheduled for a surgical consultation. ICD-10 code K80.10 will be used for billing and coding purposes. This chronic gallbladder inflammation with gallstones diagnosis is consistent with the patient's clinical presentation and imaging results.