ICD-10 Coding for Diverticulitis with Abscess(K57.32, K57.33, K57.20)
Complete ICD-10-CM coding and documentation guide for Diverticulitis with Abscess. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diverticulitis with Abscess
K57.3-K57.8Primary Range
Diverticular disease of intestine
This range includes codes for diverticulitis with and without perforation or abscess, specifying the location within the intestine.
Peritoneal abscess
Used when an abscess extends beyond the bowel wall into the peritoneal cavity.
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 | Diverticulitis of large intestine without perforation or abscess | Use when diverticulitis is confirmed in the sigmoid colon without any perforation or abscess. |
|
| K57.33 | Diverticulitis of large intestine with perforation and abscess | Use when there is documented perforation and abscess in the sigmoid colon. |
|
| K57.20 | Diverticulitis of large intestine with perforation and abscess without bleeding | Use when diverticulitis with perforation and abscess is confirmed in the large intestine, excluding sigmoid. |
|
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 Diverticulitis with Abscess
Primary ICD-10-CM Codes for diverticulitis with abscess
Decision Criteria
clinical Criteria
- Absence of perforation or abscess in sigmoid colon
Applicable To
- Sigmoid diverticulitis without perforation or abscess
Excludes
- Diverticulitis with perforation or abscess (K57.33)
Clinical Validation Requirements
- Clinical documentation of sigmoid diverticulitis without evidence of perforation or abscess
Code-Specific Risks
- Misclassification if abscess or perforation is present
Coding Notes
- Ensure clear documentation of the absence of perforation or abscess.
K57.33 - Diverticulitis of large intestine with perforation and abscess
Use when there is documented perforation and abscess in the sigmoid colon.
Applicable To
- Sigmoid diverticulitis with perforation and abscess
Excludes
- Diverticulitis without perforation or abscess (K57.32)
Clinical Validation Requirements
- CT evidence of perforation and abscess in the sigmoid colon
- Elevated WBC and CRP levels
Coding Notes
Ensure documentation specifies the location and presence of perforation and abscess.
K57.20 - Diverticulitis of large intestine with perforation and abscess without bleeding
Use when diverticulitis with perforation and abscess is confirmed in the large intestine, excluding sigmoid.
Applicable To
- Diverticulitis of colon with perforation and abscess
Excludes
- Diverticulitis with bleeding
Clinical Validation Requirements
- CT confirmation of perforation and abscess in the large intestine
- Absence of bleeding
Coding Notes
Ensure documentation excludes bleeding and specifies location.
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 Diverticulitis with 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: Inaccurate clinical picture, Regulatory: Non-compliance with coding standards, Financial: Potential under-coding affecting reimbursement
Mitigation Strategy
Use standardized templates for documentation, Ensure radiology reports include size measurements
Impact
Reimbursement: May lead to incorrect DRG assignment and reimbursement, Compliance: Non-compliance with coding guidelines, Data Quality: Decreases accuracy of clinical data
Mitigation Strategy
Ensure documentation specifies the exact location and presence of perforation or abscess.
Impact
Using unspecified codes when specific codes are applicable
Mitigation Strategy
Implement thorough documentation review processes
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 Diverticulitis with Abscess, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticulitis with Abscess
Use these documentation templates to ensure complete and accurate documentation for Diverticulitis with Abscess. These templates include all required elements for proper coding and billing.
Acute Sigmoid Diverticulitis with Abscess
Specialty: GastroenterologyRequired Elements
- CT findings
- Abscess size and location
- Presence of perforation
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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