Wiki Diverticulosis with diverticulitis?

[jerijoa]

If a patient is diagnosed with diverticulosis with diverticulitis, does the diagnosis of diverticulitis assume the presence of diverticulosis? They read to me like two different diseases and would need two separate codes: K57.90, Diverticulosis of intestine, part unspecified... and K57.92, Diverticulitis of of intestine, part unspecified... Or would I just code the K57.92? Thank you so much!

 

[tambrilin]

I used to code for colon/rectal surgery. First off - you need to ask the physician if it was the colon, small intestines or both and whether there was any bleeding. The ICD 9 code for Diverticulosis with diverticulitis was 562.11 for the Colon and 562.01 for Small Intestines. When you use the ICD 10 Code Translator at the following link... https://www.aapc.com/icd-10/codes/ this is what it comes up with for 562.11 = K57.32 which is Diverticulitis of large intestine without perforation or abscess without bleeding. And for 562.01 = K57.12 which is Diverticulitis of small intestine without perforation or abscess without bleeding. So that would be K57.52 for both, which is Diverticulitis of both small and large intestine without perforation or abscess without bleeding. If bleeding occured then it would either be K57.13, K57.33, and K57.53. Hope that helps.

 

[Colliemom]

Every patient who has diverticulitis has diverticulosis, but not every patient who has diverticulosis will have diverticulitis.

Therefore, when you are billing diverticulitis you do not need to add the dx of diverticulosis, as we know they have it or they would not have diverticulitis.

But conversely, not every patient who has diverticulosis will develop diverticulitis, so you would not automatically bill for diverticulitis...