Health data standards and systems

Can the Committee please clarify the coding of acute on chronic cholecystitis not with cholelithiasis. When there is a final diagnosis of acute on chronic cholecystitis, can both these codes be assigned?

There is some confusion here surrounding the advice in 10-AM Commandment Volume 12, number 4 titled Cholelithiasis with acute on chronic cholecystitis which says:
There has been confusion regarding the correct code assignment for this condition as there are no further index entries for the term 'chronic' under the lead term 'Cholecystitis'.

Classification:
Only one code K80.0- Calculus of gallbladder with acute cholecystitis is required for this condition. The index pathways are as follows:

Calculus, calculi, calculous
- gallbladder K80.2
- - - with cholecystitis (chronic) K80.1
- - - - acute K80.0- Cholelithiasis (cystic duct) (gallbladder) (impacted) (multiple) K80.2
- - with cholecystitis (chronic) K80.1
- - - acute K80.0-

As the term 'chronic' is a nonessential modifier in the index pathways, the chronic condition need not be coded separately (ACS 0001 Principal Diagnosis, Acute and chronic conditions).

This advice seems to apply to acute on chronic cholecystitis with cholelithiasis, but if there are no stones detected, can both K81.0 Acute cholecystitis, and K81.1 Chronic cholecystitis be assigned? Does the committee agree with this: Cholelithiasis with acute on chronic cholecystitis – do not code the chronic cholecystitis. Acute on chronic cholecystitis (w/o stones) – then both the acute and chronic cholecystitis is to be coded.

This query was originally published in March 2013 and previously retired on 30 June 2010. It was reinstated effective 1 July 2020 following a review as the advice is considered current.

VICC agrees to assign a code for both acute and chronic cholecystitis without cholelithiasis.

This is in accordance with ACS 0001 Principal diagnosis under section Acute and chronic conditions which says:
If a condition is described as both acute (subacute) and chronic and separate subterms exist in the Alphabetic Index at the same indentation level, code both and sequence the acute (subacute) code first.