ICD-10 Coding for Diverticulitis Unspecified(K57.92)
Complete ICD-10-CM coding and documentation guide for Diverticulitis Unspecified. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diverticulitis Unspecified
K57.9Primary Range
Diverticulitis of intestine, part unspecified
This range includes codes for diverticulitis without specification of the affected intestinal part.
Key Information: ICD-10 code for diverticulitis unspecified
Essential facts and insights about Diverticulitis Unspecified
Primary ICD-10-CM Code for diverticulitis unspecified
Decision Criteria
clinical Criteria
- No evidence of perforation or abscess on imaging
documentation Criteria
- Location of diverticulitis is not specified
Applicable To
- Acute diverticulitis without complications
Excludes
- Diverticulitis with perforation or abscess (K57.3-)
Clinical Validation Requirements
- CT scan showing colonic wall thickening without abscess
- CRP > 5 mg/dL
- WBC > 10,000/μL
Code-Specific Risks
- Assuming location without documentation
- Coding as complicated when no complications are documented
Coding Notes
- Ensure documentation specifies absence of complications to use K57.92.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diverticulitis Unspecified to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.92.
Impact
Clinical: May lead to incorrect diagnosis coding., Regulatory: Potential audit risk., Financial: Incorrect reimbursement due to coding errors.
Mitigation Strategy
Ensure imaging results are documented, Verify documentation before coding
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use specific codes like K57.32 for sigmoid diverticulitis.
Impact
Incomplete documentation can lead to incorrect coding.
Mitigation Strategy
Implement thorough documentation practices.
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 Diverticulitis Unspecified, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticulitis Unspecified
Use these documentation templates to ensure complete and accurate documentation for Diverticulitis Unspecified. These templates include all required elements for proper coding and billing.
Emergency Department Presentation
Specialty: Emergency MedicineRequired Elements
- Patient history
- Physical examination findings
- Imaging results
- Laboratory data
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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