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ICD-10 Coding for Colonic Diverticulosis(K57.30, K57.31)

Complete ICD-10-CM coding and documentation guide for Colonic Diverticulosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Diverticular Disease of the ColonDiverticulosis of the Large Intestine

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Related ICD-10 Code Ranges

Complete code families applicable to Colonic Diverticulosis

K57.30-K57.31Primary Range

Diverticulosis of large intestine without perforation, abscess, or bleeding

This range covers colonic diverticulosis with and without bleeding, without complications like perforation or abscess.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
K57.30Diverticulosis of large intestine without perforation or abscess, without bleedingUse when diverticulosis is present without bleeding or other complications.
  • Colonoscopy showing diverticula without bleeding
  • CT scan confirming absence of inflammation
K57.31Diverticulosis of large intestine without perforation or abscess, with bleedingUse when diverticulosis is present with confirmed bleeding.
  • Colonoscopy confirming diverticular bleeding
  • CT angiography showing bleeding source

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 colonic diverticulosis

Essential facts and insights about Colonic Diverticulosis

The ICD-10 code for colonic diverticulosis without bleeding is K57.30, and with bleeding is K57.31.

Primary ICD-10-CM Codes for colonic diverticulosis

K57.30
Diverticulosis of large intestine without perforation or abscess, without bleeding
Billable Code

Decision Criteria

clinical Criteria

  • No signs of bleeding or inflammation

Applicable To

  • Diverticulosis of colon without complications

Excludes

Clinical Validation Requirements

  • Colonoscopy showing diverticula without bleeding
  • CT scan confirming absence of inflammation

Code-Specific Risks

  • Confusion with diverticulitis coding

Coding Notes

  • Ensure documentation specifies absence of bleeding and complications.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Right upper quadrant pain

R10.11
Use if patient presents with abdominal pain.

Melena

K92.1
Use if melena is present alongside diverticular bleeding.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Diverticulitis of large intestine without perforation or abscess

K57.32
Presence of inflammation or infection differentiates diverticulitis from diverticulosis.

Diverticulitis of large intestine with bleeding

K57.33
Active inflammation or infection with bleeding differentiates this from diverticulosis with bleeding.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Colonic 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 under-treatment of bleeding complications., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for bleeding complications.

Mitigation Strategy

Train staff on documentation standards, Use checklists for colonoscopy reports

Impact

Reimbursement: Incorrect coding can lead to inappropriate DRG assignment., Compliance: May result in audit discrepancies., Data Quality: Affects accuracy of patient records.

Mitigation Strategy

Ensure documentation specifies absence of inflammation for diverticulosis.

Impact

Reimbursement: May affect reimbursement rates if bleeding is not coded., Compliance: Leads to potential compliance issues during audits., Data Quality: Impacts clinical data integrity.

Mitigation Strategy

Always confirm and document bleeding status explicitly.

Impact

Coding diverticulitis instead of diverticulosis due to unclear documentation.

Mitigation Strategy

Implement documentation audits and training.

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 Colonic Diverticulosis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Colonic Diverticulosis

Use these documentation templates to ensure complete and accurate documentation for Colonic Diverticulosis. These templates include all required elements for proper coding and billing.

Routine colonoscopy finding

Specialty: Gastroenterology

Required Elements

  • Location of diverticula
  • Presence or absence of bleeding
  • Absence of inflammation

Example Documentation

Assessment: Diverticulosis of sigmoid colon without bleeding or inflammation. Plan: High-fiber diet.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Diverticular disease noted.
Good Documentation Example
Multiple diverticula in sigmoid colon without bleeding or inflammation.
Explanation
The good example specifies location and absence of complications, ensuring accurate coding.

Need help with ICD-10 coding for Colonic Diverticulosis? Ask your questions below.

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