ICD-10: K90.82

Short bowel syndrome (SBS) is a complex condition characterized by the malabsorption of nutrients due to the surgical removal or congenital absence of a significant portion of the small intestine. The ICD-10-CM code for this condition is K90.82, which falls under the broader category of intestinal malabsorption disorders.

Clinical Description of Short Bowel Syndrome

Definition and Causes

Short bowel syndrome occurs when the small intestine is unable to absorb enough nutrients and fluids due to a reduced functional length. This can result from various causes, including:

• Surgical Resection: The most common cause of SBS is surgical removal of a portion of the small intestine, often due to conditions such as Crohn's disease, cancer, trauma, or congenital defects.
• Congenital Conditions: Some individuals may be born with a shorter than normal small intestine, leading to SBS.
• Diseases Affecting the Intestine: Conditions like ischemia or severe infections can also lead to the loss of intestinal length.

Symptoms

Patients with short bowel syndrome may experience a range of symptoms, including:

• Diarrhea: Frequent, watery stools due to unabsorbed nutrients.
• Dehydration: Resulting from excessive fluid loss.
• Malnutrition: Deficiencies in vitamins, minerals, and other nutrients due to impaired absorption.
• Weight Loss: Significant weight loss can occur as the body fails to absorb adequate calories.
• Fatigue: General tiredness due to malnutrition and dehydration.

Diagnosis

Diagnosis of SBS typically involves a combination of clinical evaluation and diagnostic tests, including:

• Medical History: A thorough review of the patient’s surgical history and symptoms.
• Physical Examination: Assessment of nutritional status and hydration levels.
• Imaging Studies: Techniques such as CT scans or MRI may be used to evaluate the anatomy of the intestines.
• Endoscopy: Procedures like colonoscopy can help assess the condition of the remaining bowel.

Treatment

Management of short bowel syndrome focuses on optimizing nutrient absorption and preventing complications. Treatment options may include:

• Nutritional Support: Patients may require specialized diets, including enteral nutrition or parenteral nutrition (intravenous feeding) if oral intake is insufficient.
• Medications: Medications to slow intestinal transit time, such as loperamide, may be prescribed to reduce diarrhea.
• Surgical Interventions: In some cases, surgical procedures may be performed to lengthen the remaining intestine or create a more effective absorption area.

Coding and Billing Considerations

The ICD-10-CM code K90.82 specifically identifies short bowel syndrome and is essential for accurate medical billing and coding. It is crucial for healthcare providers to document the condition thoroughly to ensure appropriate reimbursement and care management.

Future Coding Changes

As of 2025, the ICD-10-CM code for short bowel syndrome remains K90.82, indicating that it will continue to be recognized in the coding system for the foreseeable future[1][10].

In summary, short bowel syndrome is a significant medical condition that requires careful management and monitoring. Understanding its clinical implications, symptoms, and treatment options is vital for healthcare providers to deliver effective care to affected patients.

Short bowel syndrome (SBS) is a complex condition that arises when a significant portion of the small intestine is missing or has been surgically removed, leading to malabsorption of nutrients. The ICD-10-CM code for short bowel syndrome is K90.82. Understanding the clinical presentation, signs, symptoms, and patient characteristics associated with this condition is crucial for effective diagnosis and management.

Clinical Presentation

Definition and Causes

Short bowel syndrome typically occurs following surgical resections due to conditions such as Crohn's disease, trauma, or congenital defects. The extent of the bowel resection directly influences the severity of the syndrome, as the remaining intestine may not be sufficient to absorb nutrients adequately[1][2].

Signs and Symptoms

Patients with short bowel syndrome may exhibit a range of signs and symptoms, which can vary based on the length of the remaining intestine and the presence of any underlying conditions. Common symptoms include:

• Diarrhea: Frequent, watery stools are a hallmark of SBS due to rapid transit through the intestines and inadequate absorption of fluids and nutrients[3].
• Weight Loss: Patients often experience significant weight loss due to malabsorption and inadequate caloric intake[4].
• Nutritional Deficiencies: Deficiencies in vitamins and minerals, particularly fat-soluble vitamins (A, D, E, K), vitamin B12, and electrolytes, can occur, leading to various health issues[5].
• Abdominal Pain and Cramping: Many patients report abdominal discomfort, which can be exacerbated by food intake[6].
• Dehydration: Due to excessive fluid loss from diarrhea, dehydration is a common concern, necessitating careful management of fluid and electrolyte balance[7].

Additional Symptoms

Other symptoms may include:
- Fatigue: Resulting from malnutrition and dehydration.
- Bloating and Gas: Due to fermentation of undigested food in the intestines.
- Steatorrhea: Fatty stools that indicate malabsorption of fats[8].

Patient Characteristics

Demographics

Short bowel syndrome can affect individuals of all ages, but it is more commonly diagnosed in adults who have undergone bowel resections due to chronic conditions like Crohn's disease. Pediatric cases may arise from congenital anomalies or surgical interventions for necrotizing enterocolitis[9].

Comorbidities

Patients with SBS often have comorbid conditions that complicate their management. These may include:
- Inflammatory Bowel Disease (IBD): Such as Crohn's disease, which is a leading cause of bowel resections[10].
- Diabetes: Particularly in patients with a history of bowel surgery, which can affect nutrient absorption and metabolism[11].
- Heart Disease: Due to the nutritional deficiencies and dehydration that can impact overall health[12].

Treatment Considerations

Management of short bowel syndrome typically involves a multidisciplinary approach, including:
- Nutritional Support: Patients may require specialized diets, enteral nutrition, or parenteral nutrition (intravenous feeding) to meet their nutritional needs[13].
- Medications: Antidiarrheal agents, proton pump inhibitors, and medications to manage underlying conditions may be prescribed[14].
- Surgical Interventions: In some cases, surgical procedures such as bowel lengthening or intestinal transplantation may be considered for severe cases[15].

Conclusion

Short bowel syndrome is a serious condition characterized by significant malabsorption due to the loss of a substantial portion of the small intestine. The clinical presentation includes symptoms such as diarrhea, weight loss, and nutritional deficiencies, which can severely impact a patient's quality of life. Understanding the signs, symptoms, and patient characteristics associated with SBS is essential for healthcare providers to implement effective management strategies and improve patient outcomes. Regular monitoring and a tailored approach to nutrition and care are critical for managing this complex syndrome effectively.

Short bowel syndrome (SBS) is a complex condition that arises when a significant portion of the small intestine is missing or has been surgically removed, leading to malabsorption of nutrients. The diagnosis of SBS, particularly for the ICD-10-CM code K90.82, involves several criteria and considerations. Below is a detailed overview of the diagnostic criteria and relevant factors.

Diagnostic Criteria for Short Bowel Syndrome (ICD-10 Code K90.82)

1. Clinical History

• Surgical History: A history of surgical procedures that result in the removal of a substantial portion of the small intestine, such as resections due to Crohn's disease, trauma, or congenital defects, is critical for diagnosis.
• Symptoms: Patients typically present with symptoms of malabsorption, which may include chronic diarrhea, weight loss, dehydration, and nutritional deficiencies.

2. Nutritional Assessment

• Malnutrition: Evaluation of nutritional status is essential. Patients may exhibit signs of malnutrition, including deficiencies in vitamins and minerals, which can be assessed through blood tests and clinical evaluation.
• Dietary Intake: A detailed dietary history can help determine the extent of malabsorption and the need for nutritional support.

3. Diagnostic Testing

• Imaging Studies: Imaging techniques such as abdominal X-rays, CT scans, or MRI may be used to assess the anatomy of the gastrointestinal tract and confirm the extent of bowel loss.
• Endoscopy: In some cases, endoscopic procedures may be performed to evaluate the remaining bowel and assess for any complications.

4. Functional Assessment

• Stool Studies: Fecal fat tests can help quantify malabsorption by measuring the amount of fat in the stool, which is indicative of the intestine's ability to absorb nutrients.
• Intestinal Transit Studies: These studies can assess how quickly food moves through the digestive tract, providing insight into the functional capacity of the remaining bowel.

5. Exclusion of Other Conditions

• Differential Diagnosis: It is important to rule out other causes of malabsorption, such as celiac disease, pancreatic insufficiency, or infections, which may mimic the symptoms of SBS.

6. ICD-10-CM Coding Guidelines

• The ICD-10-CM code K90.82 specifically refers to short bowel syndrome without mention of complications. Accurate coding requires documentation of the clinical findings and the extent of bowel loss, as well as any associated conditions that may affect treatment and management.

Conclusion

The diagnosis of short bowel syndrome (ICD-10 code K90.82) is multifaceted, requiring a thorough clinical evaluation, nutritional assessment, and appropriate diagnostic testing. Clinicians must consider the patient's surgical history, symptoms, and results from various tests to confirm the diagnosis and rule out other potential causes of malabsorption. Proper documentation and coding are essential for effective management and reimbursement in clinical practice.

Short bowel syndrome (SBS), classified under ICD-10 code K90.82, is a condition that arises when a significant portion of the small intestine is missing or has been surgically removed, leading to malabsorption of nutrients. The management of SBS is multifaceted, focusing on nutritional support, symptom management, and addressing complications. Below is a detailed overview of standard treatment approaches for this condition.

Nutritional Management

1. Dietary Modifications

• High-Calorie Diet: Patients are often advised to consume a high-calorie, high-protein diet to compensate for nutrient malabsorption. This may include frequent small meals throughout the day to maximize nutrient intake[1].
• Specific Nutrient Focus: Emphasis is placed on easily digestible foods and those rich in specific nutrients that may be poorly absorbed, such as carbohydrates and fats. Patients may also need to limit fiber intake to reduce gastrointestinal distress[2].

2. Oral Nutritional Supplements

• Supplemental Nutrition: Many patients benefit from oral nutritional supplements that provide concentrated sources of calories and nutrients, which can help meet their dietary needs without excessive food volume[3].

3. Parenteral Nutrition (PN)

• Total Parenteral Nutrition (TPN): For patients with severe malabsorption or those unable to meet their nutritional needs through oral intake, TPN may be necessary. This involves delivering nutrients directly into the bloodstream, bypassing the gastrointestinal tract entirely[4].

Pharmacological Interventions

1. Medications to Enhance Absorption

• Loperamide: This medication may be used to slow intestinal transit time, allowing for better absorption of nutrients[5].
• Antibiotics: In cases where bacterial overgrowth occurs, antibiotics may be prescribed to manage this complication, which can further impair nutrient absorption[6].

2. Hormonal Therapies

• Glucagon-like Peptide-2 (GLP-2): This hormone can promote intestinal growth and enhance nutrient absorption. It is available as a medication (teduglutide) and may be beneficial for some patients with SBS[7].

Surgical Options

1. Intestinal Lengthening Procedures

• In select cases, surgical interventions such as bowel lengthening procedures may be considered to increase the absorptive surface area of the intestine, although these are typically reserved for specific patient populations[8].

2. Bowel Transplantation

• For patients with severe SBS who do not respond to other treatments, bowel transplantation may be an option. This is a complex procedure and is usually considered a last resort due to the risks involved[9].

Monitoring and Follow-Up

1. Regular Nutritional Assessments

• Continuous monitoring of nutritional status is crucial. This includes regular assessments of weight, laboratory tests to check for deficiencies, and adjustments to dietary plans as needed[10].

2. Management of Complications

• Patients with SBS are at risk for various complications, including dehydration, electrolyte imbalances, and kidney stones. Regular follow-up with healthcare providers is essential to manage these risks effectively[11].

Conclusion

The management of short bowel syndrome (ICD-10 code K90.82) requires a comprehensive approach that includes dietary modifications, pharmacological treatments, and, in some cases, surgical interventions. Each patient's treatment plan should be individualized based on the extent of their condition, nutritional needs, and overall health status. Ongoing monitoring and adjustments are vital to ensure optimal outcomes and quality of life for individuals living with this challenging condition.

Short bowel syndrome (SBS), represented by the ICD-10 code K90.82, is a complex condition that arises when a significant portion of the small intestine is missing or has been surgically removed, leading to malabsorption of nutrients. Understanding the alternative names and related terms for this condition can enhance clarity in medical documentation and communication. Below are some of the key alternative names and related terms associated with K90.82.

Alternative Names for Short Bowel Syndrome

1. Intestinal Failure: This term is often used interchangeably with short bowel syndrome, particularly when the condition results in the inability to absorb sufficient nutrients from food due to a reduced functional intestinal length.

2. Short Gut Syndrome: This is another common term that emphasizes the shortened length of the intestine, which is a hallmark of the condition.

3. Malabsorption Syndrome: While this term is broader and can refer to various conditions that impair nutrient absorption, it is relevant in the context of short bowel syndrome, as patients often experience malabsorption due to the reduced surface area of the intestine.

4. Post-Resection Syndrome: This term may be used when short bowel syndrome develops following surgical resection of the intestine, highlighting the surgical aspect of the condition.

5. Chronic Intestinal Pseudo-Obstruction: Although not synonymous, this term can sometimes be related to short bowel syndrome, particularly in cases where motility issues complicate nutrient absorption.

Related Terms and Concepts

1. Intestinal Malabsorption: This broader category includes various conditions that lead to inadequate absorption of nutrients, including short bowel syndrome.

2. Enteral Nutrition: This term refers to the delivery of nutrients directly into the gastrointestinal tract, which is often necessary for patients with short bowel syndrome who cannot absorb enough nutrients through normal eating.

3. Parenteral Nutrition: In cases where enteral nutrition is insufficient, patients may require parenteral nutrition, which involves delivering nutrients directly into the bloodstream, bypassing the digestive system.

4. Bowel Resection: This surgical procedure, which involves the removal of a portion of the intestine, is a common cause of short bowel syndrome and is often discussed in relation to the condition.

5. Ileostomy: This surgical procedure may be performed in patients with short bowel syndrome, where the end of the small intestine is brought out through the abdominal wall, allowing for waste elimination.

6. Nutritional Deficiencies: Patients with short bowel syndrome are at risk for various nutritional deficiencies due to malabsorption, making this term relevant in discussions about the condition.

Conclusion

Understanding the alternative names and related terms for short bowel syndrome (ICD-10 code K90.82) is essential for healthcare professionals involved in the diagnosis, treatment, and management of this condition. These terms not only facilitate clearer communication but also help in the comprehensive understanding of the complexities associated with short bowel syndrome and its impact on patient health.