Health data standards and systems

Could VICC please advise the correct diagnosis code to assign for documentation of angioectasia?

We have seen documentation of angioectasia of the duodenum or jejunum treated with argon plasma coagulation. Research online indicates gastrointestinal angioectasia are the most common gastrointestinal tract vascular anomaly and are characterized by ectatic, dilated, thin-walled vessels in the submucosa or mucosa. Angiectoasias are often located in the colon, and are less often located in the upper gastrointestinal tract and small bowel. Small bowel angioectasias have been reported to be the source of obscure gastrointestinal bleeding.

Research online also indicates the term angiodysplasia has been used interchangeably with angioectasia, though there has been debate over these terms equivalence. There is no specific index pathway for ‘angioectasia’. Possible Index pathways which have been considered for small intestine angioectasia include:
• Angiectasis, angiectopia I99
• Disorder / intestine, intestinal / vascular / specified NEC K55.8
• Angiodysplasia (caecum) (colon) K55.21
• For documentation of jejunal angioectasia: Disease, diseased / intestine / specified NEC K63.8
• For documentation of duodenal angioectasia: Disease, diseased / duodenum / specified NEC K31.88 or Angiodysplasia (caecum) (colon) / duodenum K31.81

Please advise:
1) The code to assign for jejunal angioectasia?
2) The code to assign for duodenal angioectasia?
3) The index pathway to assign for angioectasia of other sites?

VICC sought clinical advice which indicated that angioectasia and angiodysplasia can be considered as synonymous terms. Therefore, in answer to the specific questions in the query, in Eleventh Edition, follow the Index lead term Angiodysplasia (caecum) (colon) (intestine) and:

For duodenal or jejunal angioectasia, assign either:
K55.31 Angiodysplasia of small intestine, without mention of haemorrhage, or
K55.32 Angiodysplaysia of small intestine, with haemorrhage as appropriate.

For angioectasia of stomach, assign either:
K31.81 Angiodysplasia of stomach without mention of haemorrhage, or
K31.82 Angiodysplasia of stomach with haemorrhage as appropriate.

For angioectasia of other sites or not further specified, assign either:
K55.21 Angiodysplasia of colon without mention of haemorrhage, or
K55.22 Angiodysplasia of colon with haemorrhage as appropriate.

VICC notes that the Index was updated for Eleventh Edition as the previous entries for angiodysplasia did not include modifiers for small intestine other than duodenum. Sites other than duodenum or stomach were classified to K55.2- Angiodysplasia of colon in Tenth Edition.

Note: This query has been retired due to the creation of Index entries for angioectasia and angiodysplasia in Twelfth Edition.