ICD-10 Coding for Intra-abdominal Abscess(K65.1, K57.20)
Complete ICD-10-CM coding and documentation guide for Intra-abdominal Abscess. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Intra-abdominal Abscess
K65-K67Primary Range
Disorders of peritoneum
This range includes codes for peritoneal abscesses and related conditions.
Diverticular disease of intestine
Includes codes for diverticulitis with abscess, relevant when abscess is secondary to diverticulitis.
Other diseases of intestine
Includes codes for intestinal abscesses, relevant for abscesses localized within the bowel wall.
Diseases of liver
Includes codes for liver abscesses, relevant for abscesses located in the liver.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K65.1 | Peritoneal abscess | Use when imaging confirms a peritoneal abscess unrelated to organ-specific pathology. |
|
| K57.20 | Diverticulitis of large intestine with perforation and abscess | Use when diverticulitis is the primary condition leading to abscess formation. |
|
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 intra-abdominal abscess
Essential facts and insights about Intra-abdominal Abscess
Primary ICD-10-CM Codes for intra-abdominal abscess
Decision Criteria
clinical Criteria
- CT or MRI confirmation of peritoneal abscess
coding Criteria
- Sequence K57.20 before K65.1 if diverticulitis is present
Clinical Validation Requirements
- CT or MRI showing peritoneal fluid collection
- Elevated white blood cell count
Code-Specific Risks
- Incorrect sequencing with diverticulitis codes
Coding Notes
- Ensure imaging confirms the abscess location and etiology.
K57.20 - Diverticulitis of large intestine with perforation and abscess
Use when diverticulitis is the primary condition leading to abscess formation.
Applicable To
- Diverticulitis with abscess
Excludes
- Peritoneal abscess (K65.1)
Clinical Validation Requirements
- Documentation of perforated diverticulitis with abscess formation
Coding Notes
Ensure diverticulitis is documented as the cause of the abscess.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Diverticulitis of large intestine with perforation and abscess
K57.20Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Intra-abdominal Abscess to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K65.1.
Impact
Clinical: Potential misdiagnosis, Regulatory: Non-compliance with coding standards, Financial: Denied claims due to insufficient documentation
Mitigation Strategy
Ensure imaging reports specify abscess location, Include detailed clinical notes
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Sequence K57.20 before K65.1 when diverticulitis is present.
Impact
Improper sequencing of primary and secondary codes.
Mitigation Strategy
Follow coding guidelines for sequencing.
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 Intra-abdominal Abscess, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Intra-abdominal Abscess
Use these documentation templates to ensure complete and accurate documentation for Intra-abdominal Abscess. These templates include all required elements for proper coding and billing.
Intra-abdominal abscess secondary to diverticulitis
Specialty: GastroenterologyRequired Elements
- Patient history
- Imaging results
- Lab findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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