ICD-10 Coding: Diverticulosis

ICD-10 Coding: Diverticulosis

Diverticulosis develops when diverticula (pouches) form in the wall of the large intestine or colon. Physicians suspect that diverticula form when high pressure inside the colon pushes against the weak spots in the colon wall. When feces are trapped in the diverticula, bacteria grow. This can lead to inflammation or infection, called diverticulitis.

Diverticulitis can be very painful and last from a few hours to a week, or more. Symptoms include abdominal pain that may become worse with movement, fever and chills, bloating and gas, diarrhea or constipation, nausea (with possible vomiting), and loss of appetite.

Documentation elements for diverticulitis are location (small intestine, large intestine, or small and large intestine), as well as any manifestations or complications, to include:

  • Perforation
  • Abscess
  • Bleeding
  • Peritonitis
  • Sepsis
  • Fistula
  • Bowel obstruction

In ICD-10-CM, diverticular disease of intestine, or diverticulitis is coded to K57. The codes include location (small, large or small and large intestine), with or without perforation or abscess, and with or without bleeding:

  • K57.00 Diverticulitis of small intestine with perforation and abscess without bleeding
  • K57.01 Diverticulitis of small intestine with perforation and abscess with bleeding
  • K57.12 Diverticulitis of small intestine without perforation or abscess without bleeding
  • K57.13 Diverticulitis of small intestine without perforation or abscess with bleeding
  • K57.20 Diverticulitis of large intestine with perforation and abscess without bleeding
  • K57.21 Diverticulitis of large intestine with perforation and abscess with bleeding
  • K57.32 Diverticulitis of large intestine without perforation or abscess without bleeding
  • K57.33 Diverticulitis of large intestine without perforation or abscess with bleeding
  • K57.40 Diverticulitis of both small and large intestine with perforation and abscess without bleeding
  • K57.41 Diverticulitis of both small and large intestine with perforation and abscess with bleeding
  • K57.52 Diverticulitis of both small and large intestine without perforation or abscess without bleeding
  • K57.53 Diverticulitis of both small and large intestine without perforation or abscess with bleeding
  • K57.80 Diverticulitis of intestine, part unspecified, with perforation and abscess without bleeding
  • K57.81 Diverticulitis of intestine, part unspecified, with perforation and abscess with bleeding
  • K57.92 Diverticulitis of intestine, part unspecified, without perforation or abscess without bleeding
  • K57.93 Diverticulitis of intestine, part unspecified, without perforation or abscess with bleeding

For example: A 64-year-old male is seen for follow-up of diverticulitis. Without documentation of location or complications, the correct code is K57.92.

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John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 404 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

4 Responses to “ICD-10 Coding: Diverticulosis”

  1. Ann Devine, CPC says:

    I have seen pathology reports of diverticulitis that mention perforation, but not specifically abscess (and vice-versa). Are these two complications always linked? One of our coders has suggested that perforation derives from a ruptured abscessed diverticula, which makes sense. However, I’m hesitant to code for both manifestations if only one is mentioned in the pathology report. I hope there is some documentation you know of that shows these as usually occurring together. If not, should I be coding for diverticulitis without complications, and separately for the perforation or abscess?

  2. Imani Brown says:

    I gather my final code based on the path report. But the code for diverticulitis sates with perforation and abscess what is to be determined is was there bleeding. Did the patient in the midst of the operation or based on the physician’s documentation have bleeding/coagulopathy. Your choice will always be with perforation and abscess w/wo bleeding or with perforation or abscess w/wo bleeding. I hope this helps. You can post the op note and path report if you would like me to review further.

  3. Imani Brown says:

    *Correction

    with perforation and abscess with bleeding
    with perforation and abscess without bleeding
    without perforation or abscess with bleeding
    without perforation or abscess without bleeding

    with specificity to the large or small intestine

  4. Ann Devine, CPC says:

    One of our other coders found some helpful info in the guidelines, stating that descriptions of ICD-10 codes that have “and” as part of the description can be read as “and/or”, so the codes for diverticulitis with perforation and abscess can be for either or both. Thank you for your input!

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