ICD-10 Coding for Appendicitis(K35.2, K35.3, K35.8)
Complete ICD-10-CM coding and documentation guide for Appendicitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Appendicitis
K35-K37Primary Range
Diseases of appendix
This range includes all codes related to appendicitis, covering various presentations and complications.
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 generalized peritonitis | Use when imaging or surgical findings confirm generalized peritonitis. |
|
| K35.3 | Acute appendicitis with localized peritonitis | Use when inflammation is confined to the appendix. |
|
| K35.8 | Other acute appendicitis | Use for atypical presentations not fitting other specific codes. |
|
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 appendicitis with peritonitis
Essential facts and insights about Appendicitis
Primary ICD-10-CM Codes for appendicitis
Decision Criteria
clinical Criteria
- Generalized peritonitis confirmed by imaging or surgery.
Applicable To
- Ruptured appendix with peritonitis
Excludes
- Appendicitis without peritonitis
Clinical Validation Requirements
- CT: Extraluminal air, abscess extending beyond appendix
- WBC >15k
Code-Specific Risks
- Misclassification if peritonitis is not generalized.
Coding Notes
- Ensure documentation specifies the extent of peritonitis.
K35.3 - Acute appendicitis with localized peritonitis
Use when inflammation is confined to the appendix.
Applicable To
- Appendicitis with localized inflammatory changes
Excludes
- Generalized peritonitis
Clinical Validation Requirements
- Ultrasound: Appendiceal diameter >6mm with hyperemia
- CRP >50 mg/L
Coding Notes
Document the extent of inflammation clearly.
K35.8 - Other acute appendicitis
Use for atypical presentations not fitting other specific codes.
Applicable To
- Atypical presentations such as serositis without confirmed peritonitis
Excludes
- Appendicitis with peritonitis
Clinical Validation Requirements
- Histopathology: Florid acute appendicitis with serositis
Coding Notes
Ensure documentation supports atypical presentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Appendicitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K35.2.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure detailed documentation of clinical findings., Use specific ICD-10 codes based on clinical evidence.
Impact
Reimbursement: Incorrect DRG assignment may affect reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use K35.8 unless peritonitis is confirmed.
Impact
Increased audit risk when using unspecified codes like K35.9.
Mitigation Strategy
Ensure documentation supports the most specific code available.
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 Appendicitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Appendicitis
Use these documentation templates to ensure complete and accurate documentation for Appendicitis. These templates include all required elements for proper coding and billing.
Emergency Department Evaluation
Specialty: Emergency MedicineRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Laboratory results
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Appendicitis? Ask your questions below.