ICD-10 Coding for Diverticular Disease(K57.30, K57.32, K57.21)
Complete ICD-10-CM coding and documentation guide for Diverticular Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diverticular Disease
K57Primary Range
Diverticular disease of intestine
This range includes all codes related to diverticulosis and diverticulitis, specifying complications such as perforation, abscess, and bleeding.
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 | Use when diverticulosis is present without any signs of inflammation or complications. |
|
| K57.32 | Diverticulitis of large intestine with bleeding | Use when diverticulitis is confirmed with bleeding. |
|
| K57.21 | Diverticulitis of large intestine with perforation and abscess | Use when both perforation and abscess are confirmed. |
|
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 diverticulitis with abscess
Essential facts and insights about Diverticular Disease
Primary ICD-10-CM Codes for diverticuli
Decision Criteria
clinical Criteria
- Absence of inflammation or abscess on imaging
Applicable To
- Uncomplicated diverticulosis
Excludes
- Diverticulitis (K57.32)
Clinical Validation Requirements
- Colonoscopy showing diverticula without signs of inflammation or abscess
Code-Specific Risks
- Misclassification if inflammation is present
Coding Notes
- Ensure no signs of inflammation or complications are documented.
K57.32 - Diverticulitis of large intestine with bleeding
Use when diverticulitis is confirmed with bleeding.
Applicable To
- Diverticulitis with hematochezia
Excludes
- Diverticulosis without bleeding (K57.30)
Clinical Validation Requirements
- CT scan showing diverticulitis with evidence of bleeding
Coding Notes
Document the presence of bleeding clearly.
K57.21 - Diverticulitis of large intestine with perforation and abscess
Use when both perforation and abscess are confirmed.
Applicable To
- Diverticulitis with perforation and abscess
Excludes
- Diverticulosis without perforation or abscess (K57.30)
Clinical Validation Requirements
- CT scan showing perforation and abscess
Coding Notes
Ensure both perforation and abscess are documented.
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 Diverticular Disease 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., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific terms like 'diverticulitis with abscess', Ensure imaging and lab results are included
Impact
Reimbursement: Incorrect coding can lead to underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use K57.21 when abscess is present.
Impact
Risk of audits due to incorrect coding of complications.
Mitigation Strategy
Regular training on documentation and coding updates.
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 Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticular Disease
Use these documentation templates to ensure complete and accurate documentation for Diverticular Disease. These templates include all required elements for proper coding and billing.
Acute Diverticulitis with Abscess
Specialty: GastroenterologyRequired Elements
- Location of diverticulitis
- Presence of abscess or perforation
- Imaging findings
- Laboratory results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Diverticular Disease? Ask your questions below.