ICD-10 Coding for Perforation of Intestine(K63.1, K57.20, K91.71)
Complete ICD-10-CM coding and documentation guide for Perforation of Intestine. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Perforation of Intestine
K63-K64Primary Range
Other diseases of intestine
This range includes codes for various intestinal conditions, including nontraumatic perforation.
Diverticular disease of intestine
Includes codes for diverticulitis with perforation, relevant when perforation is due to diverticulitis.
Intraoperative and postprocedural complications and disorders of digestive system
Includes codes for accidental puncture or laceration 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 | Perforation of intestine (nontraumatic) | Use for spontaneous perforations not linked to diverticulitis or procedures. |
|
| K57.20 | Diverticulitis of large intestine with perforation and abscess without bleeding | Use when perforation is directly linked to diverticulitis. |
|
| K91.71 | Accidental puncture/laceration of digestive organ during digestive system procedure | Use for perforations occurring during procedures. |
|
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 perforation of intestine
Essential facts and insights about Perforation of Intestine
Primary ICD-10-CM Codes for perforation of intestine
Decision Criteria
clinical Criteria
- CT scan shows extraluminal air without signs of diverticulitis.
documentation Criteria
- Provider notes confirm spontaneous perforation.
Applicable To
- Spontaneous intestinal perforation
Excludes
- Traumatic perforation
- Perforation due to diverticulitis
Clinical Validation Requirements
- CT findings of pneumoperitoneum
- Elevated WBC count
- Intraoperative confirmation of perforation
Code-Specific Risks
- Misclassification with traumatic perforation
Coding Notes
- Ensure documentation specifies nontraumatic origin.
K57.20 - Diverticulitis of large intestine with perforation and abscess without bleeding
Use when perforation is directly linked to diverticulitis.
Applicable To
- Diverticulitis with perforation
Excludes
- Diverticulitis with bleeding
Clinical Validation Requirements
- CT confirmation of diverticulitis and perforation
- Abscess formation
Coding Notes
Ensure imaging supports both diverticulitis and perforation.
K91.71 - Accidental puncture/laceration of digestive organ during digestive system procedure
Use for perforations occurring during procedures.
Applicable To
- Iatrogenic perforation during procedure
Excludes
- Non-iatrogenic perforations
Clinical Validation Requirements
- Intraoperative report of accidental injury
- Procedure notes detailing repair
Coding Notes
Document the procedure and the accidental nature of the perforation.
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.
Diverticulitis of large intestine with perforation and abscess without bleeding
K57.20Accidental puncture/laceration of digestive organ during digestive system procedure
K91.71Perforation of intestine (nontraumatic)
K63.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Perforation of Intestine to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K63.1.
Impact
Clinical: Misrepresentation of patient condition., Regulatory: Potential audit issues., Financial: Incorrect DRG assignment affects reimbursement.
Mitigation Strategy
Review complete clinical documentation, Ensure coding reflects complications
Impact
Reimbursement: Incorrect DRG assignment may lead to reimbursement errors., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use K57.20 when diverticulitis is the cause.
Impact
Failure to document accidental nature can lead to audit issues.
Mitigation Strategy
Ensure detailed operative reports are maintained.
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 Perforation of Intestine, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Perforation of Intestine
Use these documentation templates to ensure complete and accurate documentation for Perforation of Intestine. These templates include all required elements for proper coding and billing.
Post-Procedural Perforation
Specialty: GastroenterologyRequired Elements
- Procedure details
- Nature of perforation
- Intervention performed
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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