ICD-10 Coding for Colon Diverticulosis(K57.30, K57.31, K57.32)
Complete ICD-10-CM coding and documentation guide for Colon Diverticulosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colon Diverticulosis
K57.3-K57.33Primary Range
Diverticular disease of the intestine
This range includes codes for diverticulosis and diverticulitis of the large intestine, with or without complications such as bleeding or abscess.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K57.30 | Diverticulosis of large intestine without perforation or abscess without bleeding | Use when diverticulosis is present without bleeding or complications. |
|
| K57.31 | Diverticulosis of large intestine without perforation or abscess with bleeding | Use when diverticulosis is accompanied by active bleeding. |
|
| K57.32 | Diverticulitis of large intestine with perforation and abscess | Use when diverticulitis is present with perforation or abscess. |
|
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 colon diverticulosis
Essential facts and insights about Colon Diverticulosis
Primary ICD-10-CM Codes for colon diverticulosis
Decision Criteria
clinical Criteria
- Presence of diverticula without inflammation or bleeding
Applicable To
- Uncomplicated diverticulosis
Excludes
- Diverticulitis (K57.32)
Clinical Validation Requirements
- CT scan showing diverticula without wall thickening or inflammation
- Colonoscopy confirming absence of bleeding
Code-Specific Risks
- Confusing with diverticulitis, which requires different coding.
Coding Notes
- Ensure documentation specifies the absence of bleeding or complications.
K57.31 - Diverticulosis of large intestine without perforation or abscess with bleeding
Use when diverticulosis is accompanied by active bleeding.
Applicable To
- Diverticulosis with bleeding
Excludes
- Diverticulitis with bleeding (K57.33)
Clinical Validation Requirements
- Endoscopic confirmation of bleeding from diverticula
- Hemoglobin drop indicating bleeding
Coding Notes
Document the source and confirmation of bleeding.
K57.32 - Diverticulitis of large intestine with perforation and abscess
Use when diverticulitis is present with perforation or abscess.
Applicable To
- Diverticulitis with complications
Excludes
- Diverticulosis without inflammation (K57.30)
Clinical Validation Requirements
- CT scan showing wall thickening and pericolic fat stranding
- Elevated CRP and WBC count
Coding Notes
Ensure documentation specifies the presence of perforation or abscess.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Intra-abdominal abscess
K65.1Differential 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 Colon Diverticulosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.30.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Potential for audit issues., Financial: Incorrect reimbursement due to misclassification.
Mitigation Strategy
Always confirm bleeding status with endoscopy., Include hemoglobin levels in documentation.
Impact
Reimbursement: Incorrect coding can lead to denied claims or incorrect DRG assignment., Compliance: Misrepresentation of patient condition., Data Quality: Inaccurate clinical data affecting patient care.
Mitigation Strategy
Verify documentation for inflammation or infection before coding.
Impact
Inadequate documentation of bleeding can lead to audit issues.
Mitigation Strategy
Ensure endoscopic confirmation is documented.
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 Colon Diverticulosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colon Diverticulosis
Use these documentation templates to ensure complete and accurate documentation for Colon Diverticulosis. These templates include all required elements for proper coding and billing.
Diverticulosis without complications
Specialty: GastroenterologyRequired Elements
- Location of diverticula
- Absence of bleeding
- No signs of inflammation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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