ICD-10 Coding for Duodenal Diverticulum(K57.10, K57.12, K57.00)
Complete ICD-10-CM coding and documentation guide for Duodenal Diverticulum. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Duodenal Diverticulum
K57.0-K57.9Primary Range
Diverticular disease of intestine
This range includes codes for diverticular disease affecting the small intestine, including the duodenum.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K57.10 | Diverticulosis of small intestine without perforation or abscess | Use when diverticulum is found incidentally without symptoms or complications. |
|
| K57.12 | Diverticulitis of small intestine without perforation or abscess | Use when there is inflammation of the diverticulum without perforation or abscess. |
|
| K57.00 | Diverticulitis of small intestine with perforation and abscess | Use when there is perforation and/or abscess associated with diverticulitis. |
|
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 duodenal diverticulum
Essential facts and insights about Duodenal Diverticulum
Primary ICD-10-CM Codes for duodenal diverticulum
Decision Criteria
clinical Criteria
- No symptoms or complications present
Applicable To
- Asymptomatic duodenal diverticulum
Excludes
- Diverticulitis of small intestine (K57.12)
Clinical Validation Requirements
- Imaging showing diverticulum without signs of inflammation or complications
Code-Specific Risks
- Misclassification if symptoms or complications are present
Coding Notes
- Ensure documentation specifies the absence of complications.
K57.12 - Diverticulitis of small intestine without perforation or abscess
Use when there is inflammation of the diverticulum without perforation or abscess.
Applicable To
- Inflamed duodenal diverticulum
Excludes
- Diverticulosis without inflammation (K57.10)
Clinical Validation Requirements
- Elevated CRP and imaging showing inflammation
Coding Notes
Ensure documentation specifies inflammation without perforation.
K57.00 - Diverticulitis of small intestine with perforation and abscess
Use when there is perforation and/or abscess associated with diverticulitis.
Applicable To
- Perforated duodenal diverticulum
Excludes
- Diverticulitis without perforation (K57.12)
Clinical Validation Requirements
- CT/MRI showing perforation and abscess
Coding Notes
Ensure imaging confirms perforation and abscess.
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.
Diverticulosis of large intestine without perforation or abscess
K57.30Diverticulitis of small intestine with perforation and abscess
K57.00Diverticulitis of small intestine with perforation, abscess, and bleeding
K57.01Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Duodenal Diverticulum to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.10.
Impact
Clinical: Inadequate treatment planning, Regulatory: Potential for audit issues, Financial: Loss of reimbursement for higher complexity cases
Mitigation Strategy
Thorough review of imaging and lab results, Detailed clinical documentation
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure the code reflects the correct anatomical location (small intestine).
Impact
Risk of audits due to incorrect anatomical coding.
Mitigation Strategy
Regular training on anatomical coding and review of clinical documentation.
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 Duodenal Diverticulum, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Duodenal Diverticulum
Use these documentation templates to ensure complete and accurate documentation for Duodenal Diverticulum. These templates include all required elements for proper coding and billing.
Surgical Management of Perforated Diverticulum
Specialty: SurgeryRequired Elements
- Procedure details
- Findings
- Complications
- Pathology results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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