ICD-10 Code for Barrett’s Esophagus: A Complete Guide

Barrett’s esophagus is a condition where the lining of the esophagus changes due to long-term acid reflux. In this condition, normal squamous cells are replaced by intestinal-type cells, a process called esophageal intestinal metaplasia. Although not everyone with Barrett’s will develop complications, this change increases the risk of esophageal cancer.

For doctors, coders, and insurance providers, documenting Barrett’s esophagus accurately is essential. The ICD-10 code for Barrett’s esophagus is what ensures clear communication, proper billing, and correct patient management. This guide breaks down the main codes, their subcategories, how to use them, and why they matter.

Main ICD-10 Code for Barrett’s Esophagus

The base K22.7 diagnosis code is used for Barrett’s esophagus. It falls under digestive system diseases, specifically under other esophageal conditions. However, K22.7 alone is often not enough. ICD-10 offers more detailed subcodes to specify whether or not the patient has dysplasia, and if so, what grade.

Subcodes of K22.7 and Their Meaning

Accurate coding requires selecting the subcode that matches the pathology findings:

• K22.70 – Barrett’s esophagus without dysplasia
  Used when biopsy confirms intestinal metaplasia but no precancerous changes are seen. For example, a patient undergoing routine endoscopy for chronic reflux might show Barrett’s tissue, but biopsy confirms no dysplasia.

• K22.71 – Barrett’s esophagus with dysplasia
  This code is chosen when precancerous cellular changes are found. Dysplasia means the cells are starting to change abnormally, raising the risk of cancer.

  Subcategories include:

  • K22.710 – Low grade dysplasia: Early abnormal changes, often managed with close follow-up or endoscopic therapy.

  • K22.711 – High grade dysplasia: More severe changes, requiring immediate intervention due to higher cancer risk.

  • K22.719 – Unspecified dysplasia: Used if the biopsy report confirms dysplasia but does not mention the grade.

History of Barrett’s Esophagus ICD-10 Code

Sometimes, patients had Barrett’s esophagus in the past but treatment resolved it. In these cases, you do not use K22.7. Instead, coders should use Z87.11 – Personal history of diseases of the digestive system.

For example, if a patient underwent ablation therapy and follow-up biopsies show no remaining Barrett’s tissue, Z87.11 applies rather than an active diagnosis code.

Why the Right Code Matters

Choosing the right code is not just a billing exercise. It affects patient care, follow-up, and clinical data.

• For reimbursement: Insurers require precise ICD-10 coding. A nonspecific or incorrect code can delay claims.

• For surveillance: Barrett’s surveillance guidelines are tied to dysplasia grade. Someone coded with K22.70 might need endoscopy every 3-5 years, while K22.710 often requires repeat scopes within 6–12 months.

• For patient risk assessment: High grade dysplasia signals urgent intervention. Coding K22.711 ensures the patient is flagged for close monitoring.

• For research and public health: Accurate coding helps researchers track how common Barrett’s is and how often it progresses to cancer.

Common Coding Mistakes

Even experienced coders and providers sometimes make errors:

• Using K22.70 (without dysplasia) when dysplasia is present but not clearly documented.

• Defaulting to unspecified dysplasia (K22.719) when the biopsy does state low or high grade.

• Coding active Barrett’s as “history of” before pathology confirms resolution.

• Not updating the code if dysplasia progresses or regresses over time.

A good practice is to always check the most recent endoscopy and pathology report before finalizing the code.

Real-World Examples

• Case 1: No Dysplasia
  A 55-year-old man with chronic GERD undergoes endoscopy. Pathology shows intestinal metaplasia but no dysplasia. Correct code: K22.70.

• Case 2: Low Grade Dysplasia
  A woman’s biopsy reveals early precancerous changes. She is placed on a 6-month follow-up schedule. Correct code: K22.710.

• Case 3: High Grade Dysplasia
  A patient’s pathology report documents severe changes, prompting referral for endoscopic ablation. Correct code: K22.711.

• Case 4: Resolved Barrett’s
  After successful treatment, follow-up biopsies show no Barrett’s tissue. Correct code: Z87.11 for history.

Barrett’s Surveillance Guidelines

While guidelines vary by country, most follow this general structure:

• Without dysplasia (K22.70): Endoscopy every 3–5 years.

• Low grade dysplasia (K22.710): Endoscopy every 6–12 months or treatment depending on risk factors.

• High grade dysplasia (K22.711): Urgent intervention such as ablation, resection, or close surveillance every 3 months if therapy is not done.

Accurate coding ensures that patients are placed into the right surveillance schedule.

FAQs

Q1: What is the ICD-10 code for Barrett’s esophagus?
The main ICD-10 code is K22.7, with subcodes specifying whether dysplasia is present.

Q2: How do I code Barrett’s esophagus without dysplasia?
Use K22.70 when pathology confirms Barrett’s tissue but no dysplasia.

Q3: What if the biopsy shows low grade dysplasia?
That is coded as K22.710. These patients usually need more frequent endoscopy.

Q4: Which code applies to high grade dysplasia?
Use K22.711 for high grade dysplasia, as this stage carries the greatest cancer risk.

Q5: Can I use unspecified dysplasia?
Yes, but only when the report states dysplasia without specifying low or high grade. Use K22.719 in that case.

Q6: What if the patient no longer has Barrett’s?
Use Z87.11 for a personal history of Barrett’s esophagus after resolution.

Q7: Does Barrett’s esophagus always turn into cancer?
No. Only a small percentage progress to cancer, but coding dysplasia grade helps identify higher-risk patients.

Q8: How often should patients with Barrett’s esophagus be checked?
It depends on dysplasia grade. Without dysplasia, every 3–5 years. With dysplasia, more frequent follow-up is needed.

Final Thoughts

The ICD-10 code for Barrett’s esophagus is more than a billing detail. It tells the story of a patient’s risk level, directs how often they should be checked, and ensures accurate records. From K22.70 (without dysplasia) to K22.711 (high grade dysplasia), each code carries different clinical implications. Using Z87.11 for past cases also helps distinguish resolved from active disease.