ICD-10 Coding for Appendectomy(K35.2, K38.9)
Complete ICD-10-CM coding and documentation guide for Appendectomy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Appendectomy
K35-K38Primary Range
Diseases of appendix
This range includes codes for appendicitis and related conditions, which are directly relevant to appendectomy procedures.
Diseases and conditions complicating pregnancy, childbirth, and the puerperium
Used when appendicitis occurs during pregnancy, affecting the sequencing of codes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K35.2 | Acute appendicitis with peritonitis | Use when acute appendicitis with peritonitis is confirmed by imaging and clinical findings. |
|
| K38.9 | Disease of appendix, unspecified | Use when an appendectomy is performed but no specific disease of the appendix is confirmed. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for appendectomy
Essential facts and insights about Appendectomy
Primary ICD-10-CM Codes for appendectomy
Decision Criteria
clinical Criteria
- Presence of peritonitis confirmed by imaging and clinical examination.
Applicable To
- Acute appendicitis with generalized peritonitis
- Acute appendicitis with localized peritonitis
Excludes
- Chronic appendicitis (K36)
Clinical Validation Requirements
- CT scan showing appendiceal diameter >6 mm with peri-appendiceal fat stranding
- Elevated WBC >12,000/µL
- Clinical signs of peritonitis
Code-Specific Risks
- Ensure peritonitis is documented; otherwise, use K35.80.
Coding Notes
- Ensure documentation supports the presence of peritonitis.
K38.9 - Disease of appendix, unspecified
Use when an appendectomy is performed but no specific disease of the appendix is confirmed.
Excludes
- Acute appendicitis (K35.-)
Clinical Validation Requirements
- Negative imaging for appendicitis
- Normal WBC count
Coding Notes
Ensure documentation reflects the lack of specific findings.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Right lower quadrant pain
R10.31Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other acute appendicitis
K35.80Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Appendectomy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K35.2.
Impact
Clinical: Misrepresentation of patient condition., Regulatory: Potential audit failure., Financial: Denial of claims or reduced reimbursement.
Mitigation Strategy
Review imaging and clinical findings before coding., Ensure operative notes are complete.
Impact
Reimbursement: Incorrect coding may lead to overpayment or denial., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on procedure frequency.
Mitigation Strategy
Use +44955 when appendectomy is incidental to another procedure.
Impact
Using primary appendectomy codes for incidental procedures.
Mitigation Strategy
Educate coders on the use of add-on codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Appendectomy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Appendectomy
Use these documentation templates to ensure complete and accurate documentation for Appendectomy. These templates include all required elements for proper coding and billing.
Laparoscopic appendectomy
Specialty: General SurgeryRequired Elements
- Pre-op diagnosis
- Post-op diagnosis
- Operative findings
- Surgical technique
- Complications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Appendectomy? Ask your questions below.