ICD-10 Coding for Diverticular Abscess(K57.32, K57.92)
Complete ICD-10-CM coding and documentation guide for Diverticular Abscess. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diverticular Abscess
K57.3-K57.9Primary Range
Diverticular disease of intestine with perforation and abscess
This range includes codes for diverticular disease with complications such as perforation and 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 |
|---|---|---|---|
| K57.32 | Diverticular disease of large intestine with perforation and abscess | Use when there is documented perforation and abscess in the large intestine. |
|
| K57.92 | Diverticular disease of intestine, part unspecified, with perforation and abscess | Use when the location of the abscess is not specified in the documentation. |
|
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 diverticular abscess
Essential facts and insights about Diverticular Abscess
Primary ICD-10-CM Codes for diverticular abscess
Decision Criteria
clinical Criteria
- CT confirmation of abscess and perforation in the large intestine
documentation Criteria
- Explicit mention of both perforation and abscess
Applicable To
- Pericolic abscess
- Diverticulitis with abscess
Excludes
- Diverticulitis without abscess (K57.30)
Clinical Validation Requirements
- CT scan showing abscess and perforation in the large intestine
- Elevated WBC count
- Symptoms such as fever and localized tenderness
Code-Specific Risks
- Assuming perforation implies abscess without explicit documentation
Coding Notes
- Ensure documentation specifies both perforation and abscess.
K57.92 - Diverticular disease of intestine, part unspecified, with perforation and abscess
Use when the location of the abscess is not specified in the documentation.
Applicable To
- Diverticulitis with unspecified location of abscess
Excludes
- Specific location documented (K57.32 or K57.30)
Clinical Validation Requirements
- Abscess and perforation documented without specific location
- Symptoms such as fever and abdominal pain
Coding Notes
Query for specific location if possible to avoid unspecified coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Peritoneal 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 Diverticular Abscess to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.32.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Can result in coding errors and audit issues., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Ensure radiology reports include detailed findings, Educate clinicians on documentation standards
Impact
Reimbursement: Incorrect coding can lead to reduced reimbursement., Compliance: May result in compliance issues during audits., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Code based on explicit documentation of both conditions.
Impact
Audits may focus on the explicit documentation of both conditions.
Mitigation Strategy
Ensure thorough documentation and use of appropriate 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 Diverticular Abscess, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticular Abscess
Use these documentation templates to ensure complete and accurate documentation for Diverticular Abscess. These templates include all required elements for proper coding and billing.
Acute diverticulitis with abscess
Specialty: GastroenterologyRequired Elements
- Location of diverticulitis
- Presence of perforation
- Abscess size and location
- Imaging findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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