ICD-10 Coding for Perforated Viscus(K63.1, K57.21)
Complete ICD-10-CM coding and documentation guide for Perforated Viscus. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Perforated Viscus
K57-K63Primary Range
Diseases of the intestines
This range includes codes for various intestinal conditions, including perforations due to diverticulitis and other causes.
Peptic ulcer diseases
Includes codes for perforations due to ulcers in the stomach and duodenum.
Intraoperative and postprocedural complications
Covers complications such as accidental lacerations during procedures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K63.1 | Nontraumatic intestinal perforation | Use when the perforation is spontaneous and not due to a specific condition like diverticulitis or ulcer. |
|
| K57.21 | Diverticulitis of large intestine with perforation and bleeding | Use when diverticulitis causes perforation with documented bleeding. |
|
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 perforated viscus
Essential facts and insights about Perforated Viscus
Primary ICD-10-CM Codes for perforated viscus
Decision Criteria
clinical Criteria
- Presence of free air on imaging
documentation Criteria
- Specific cause of perforation documented
Applicable To
- Spontaneous perforation of intestine
Clinical Validation Requirements
- Imaging showing free air or perforation
- Clinical signs of acute abdomen
Code-Specific Risks
- Risk of undercoding if specific cause is not documented
Coding Notes
- Ensure documentation specifies the cause of perforation to select the correct code.
K57.21 - Diverticulitis of large intestine with perforation and bleeding
Use when diverticulitis causes perforation with documented bleeding.
Applicable To
- Perforation due to diverticulitis with bleeding
Excludes
- Perforation without bleeding (K57.20)
Clinical Validation Requirements
- Imaging showing perforation and bleeding
- Clinical signs of diverticulitis
Coding Notes
Ensure bleeding is clearly documented to use this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Generalized peritonitis
K65.0Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Diverticulitis of large intestine with perforation and abscess
K57.20Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Perforated Viscus to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K63.1.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Increases risk of audit and compliance issues., Financial: Potential for denied claims or reduced reimbursement.
Mitigation Strategy
Use specific terminology, Include imaging and operative details
Impact
Reimbursement: Incorrect coding can lead to lower reimbursement., Compliance: May result in coding audits and compliance issues., Data Quality: Affects the accuracy of clinical data and statistics.
Mitigation Strategy
Use K57.20 or K57.21 if diverticulitis is the cause.
Impact
Using generic codes instead of specific ones for diverticulitis.
Mitigation Strategy
Educate coders on specific documentation requirements.
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 Perforated Viscus, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Perforated Viscus
Use these documentation templates to ensure complete and accurate documentation for Perforated Viscus. These templates include all required elements for proper coding and billing.
Acute diverticulitis with perforation
Specialty: GastroenterologyRequired Elements
- Patient history of diverticulitis
- Imaging showing perforation
- Operative findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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