ICD-10 Coding for Viscus Perforation(K26.1, K57.20, K91.71)
Complete ICD-10-CM coding and documentation guide for Viscus Perforation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Viscus Perforation
K26-K28Primary Range
Ulcer of stomach and duodenum
Includes codes for perforated ulcers, a common cause of viscus perforation.
Diverticular disease of intestine
Covers diverticulitis with perforation, another frequent etiology.
Intraoperative and postprocedural complications and disorders
Includes codes for iatrogenic perforations 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 |
|---|---|---|---|
| K26.1 | Acute duodenal ulcer with perforation | Use when a duodenal ulcer is confirmed with perforation. |
|
| K57.20 | Diverticulitis of large intestine with perforation and abscess | Use when diverticulitis is confirmed with perforation. |
|
| K91.71 | Accidental puncture and laceration during a procedure | Use for iatrogenic perforations 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 viscus perforation
Essential facts and insights about Viscus Perforation
Primary ICD-10-CM Codes for viscus perforation
Decision Criteria
clinical Criteria
- Confirmed duodenal ulcer with perforation on imaging
Applicable To
- Perforated duodenal ulcer
Excludes
- Chronic duodenal ulcer with perforation
Clinical Validation Requirements
- Endoscopy or CT confirming duodenal ulcer with free air
Code-Specific Risks
- Misidentifying the ulcer location
Coding Notes
- Ensure documentation specifies ulcer location and perforation.
K57.20 - Diverticulitis of large intestine with perforation and abscess
Use when diverticulitis is confirmed with perforation.
Applicable To
- Perforated diverticulitis
Excludes
- Diverticulosis without perforation
Clinical Validation Requirements
- CT showing diverticulitis with perforation
Coding Notes
Document abscess presence and perforation clearly.
K91.71 - Accidental puncture and laceration during a procedure
Use for iatrogenic perforations during procedures.
Applicable To
- Iatrogenic perforation
Excludes
- Intentional surgical laceration
Clinical Validation Requirements
- Operative report detailing accidental injury
Coding Notes
Ensure documentation of clinical significance.
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.
Acute gastric ulcer with perforation
K27.1Diverticulitis of large intestine with perforation without abscess
K57.32Accidental puncture and laceration during other procedure
K91.72Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Viscus Perforation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K26.1.
Impact
Clinical: Inadequate treatment planning, Regulatory: Potential audit issues, Financial: Reduced reimbursement
Mitigation Strategy
Thorough documentation of surgical findings, Include impact on patient care
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate clinical data
Mitigation Strategy
Query provider for specific cause of perforation.
Impact
High risk of misclassification as intentional.
Mitigation Strategy
Detailed operative reports and clear documentation of intent.
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 Viscus Perforation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Viscus Perforation
Use these documentation templates to ensure complete and accurate documentation for Viscus Perforation. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: Emergency MedicineRequired Elements
- Onset and severity of symptoms
- Physical exam findings
- Imaging results
- Initial treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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