ICD-10 Coding for Intra-abdominal Infection(K65.1, K65.0)
Complete ICD-10-CM coding and documentation guide for Intra-abdominal Infection. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Intra-abdominal Infection
K65-K66Primary Range
Diseases of peritoneum and retroperitoneum
This range includes codes for peritoneal and intra-abdominal infections, which are central to the diagnosis.
Bacterial and viral infectious agents
These codes are used to specify the infectious organism involved in the intra-abdominal infection.
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. |
|
| K65.0 | Acute peritonitis | Use when there is acute peritonitis without abscess. |
|
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 infection
Essential facts and insights about Intra-abdominal Infection
Primary ICD-10-CM Codes for intra abdominal infection
Decision Criteria
clinical Criteria
- Presence of abscess confirmed by imaging
documentation Criteria
- Specific mention of 'abscess' in clinical notes
Applicable To
- Subphrenic abscess
- Pelvic abscess
Excludes
- Abscess of appendix (K35.3)
Clinical Validation Requirements
- Imaging confirmation (CT/US/MRI) of abscess
- Clinical symptoms such as fever and abdominal pain
Code-Specific Risks
- Incorrectly coding phlegmon as an abscess
Coding Notes
- Ensure documentation specifies the presence of an abscess.
K65.0 - Acute peritonitis
Use when there is acute peritonitis without abscess.
Applicable To
- Generalized peritonitis
Excludes
- Peritoneal abscess (K65.1)
Clinical Validation Requirements
- Clinical symptoms such as severe abdominal pain and fever
- Imaging showing inflammation without abscess
Coding Notes
Ensure documentation specifies the absence of an abscess.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Escherichia coli [E. coli] as the cause of diseases classified elsewhere
B96.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Intra-abdominal Infection to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K65.1.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific terms like 'peritoneal abscess' or 'acute peritonitis'., Ensure imaging and lab results are included in the notes.
Impact
Reimbursement: Incorrect coding may lead to lower DRG assignment., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Impacts data accuracy and quality.
Mitigation Strategy
Index phlegmon to abscess codes as per ICD-10 guidelines.
Impact
Misclassification can lead to audit findings.
Mitigation Strategy
Ensure thorough documentation and correct code selection.
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 Infection, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Intra-abdominal Infection
Use these documentation templates to ensure complete and accurate documentation for Intra-abdominal Infection. These templates include all required elements for proper coding and billing.
Suspected Intra-abdominal Infection
Specialty: General SurgeryRequired Elements
- History of present illness
- Physical examination findings
- Imaging results
- Laboratory findings
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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