ICD-10 Coding for Colon Perforation(K63.1, K57.20, K91.71)
Complete ICD-10-CM coding and documentation guide for Colon Perforation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Colon Perforation
K63-K64Primary Range
Other diseases of intestine
This range includes codes for nontraumatic perforations of the intestine, which are primary for colon perforation.
Diverticular disease of intestine
This range includes codes for diverticulitis with perforation, relevant when perforation is due to diverticular disease.
Intraoperative and postprocedural complications and disorders of digestive system
This range includes codes for postprocedural perforations, relevant when perforation occurs during or after a procedure.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K63.1 | Perforation of intestine (nontraumatic) | Use when the perforation is nontraumatic and not related to a procedure or diverticular disease. |
|
| K57.20 | Diverticulitis of large intestine with perforation and abscess without bleeding | Use when perforation is due to diverticulitis. |
|
| K91.71 | Accidental puncture and laceration of a digestive system organ or structure during a digestive system procedure | Use when perforation occurs during or as a result of a digestive procedure. |
|
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 perforation
Essential facts and insights about Colon Perforation
Primary ICD-10-CM Codes for colon perforation
Decision Criteria
clinical Criteria
- Presence of free air on imaging without recent procedure
Applicable To
- Nontraumatic perforation of colon
Excludes
- Traumatic perforation of intestine (S36.5)
Clinical Validation Requirements
- CT scan showing free air
- Elevated white blood cell count
- Peritoneal signs on physical exam
Code-Specific Risks
- Confusion with postprocedural perforation codes
Coding Notes
- Ensure documentation specifies the nontraumatic nature of the perforation.
K57.20 - Diverticulitis of large intestine with perforation and abscess without bleeding
Use when perforation is due to diverticulitis.
Applicable To
- Diverticulitis with perforation
Excludes
- Diverticulitis without perforation (K57.30)
Clinical Validation Requirements
- History of diverticulitis
- CT scan showing perforation and abscess
Coding Notes
Document the presence of diverticulitis and associated abscess.
K91.71 - Accidental puncture and laceration of a digestive system organ or structure during a digestive system procedure
Use when perforation occurs during or as a result of a digestive procedure.
Applicable To
- Iatrogenic perforation during colonoscopy
Excludes
- Nontraumatic perforation (K63.1)
Clinical Validation Requirements
- Procedure note indicating perforation
- Imaging confirming perforation post-procedure
Coding Notes
Ensure documentation includes the procedure and the occurrence of perforation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Acute peritonitis
K65.0Differential 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 Perforation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K63.1.
Impact
Clinical: Inadequate information for treatment planning, Regulatory: Non-compliance with documentation standards, Financial: Potential for claim denials
Mitigation Strategy
Use structured templates, Educate staff on documentation standards
Impact
Reimbursement: Incorrect coding may lead to denied claims or incorrect DRG assignment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Verify if the perforation is related to a procedure and use K91.71 if so.
Impact
Incorrect coding of procedure-related perforations
Mitigation Strategy
Regular audits and coder education
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 Perforation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Colon Perforation
Use these documentation templates to ensure complete and accurate documentation for Colon Perforation. These templates include all required elements for proper coding and billing.
Colon Perforation during Colonoscopy
Specialty: GastroenterologyRequired Elements
- Procedure details
- Perforation site and size
- Repair method
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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