ICD-10 Coding for Diverticulosis of the Sigmoid Colon(K57.30, K57.31)
Complete ICD-10-CM coding and documentation guide for Diverticulosis of the Sigmoid Colon. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diverticulosis of the Sigmoid Colon
K57.30-K57.31Primary Range
Diverticulosis of large intestine without perforation or abscess
These codes are used for diverticulosis in the sigmoid colon, which is part of the large intestine.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K57.30 | Diverticulosis of large intestine without perforation or abscess | Use when diverticulosis is confirmed in the sigmoid colon without complications such as bleeding. |
|
| K57.31 | Diverticulosis of large intestine with bleeding | Use when diverticulosis in the sigmoid colon is accompanied by bleeding. |
|
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 diverticulosis in the sigmoid colon
Essential facts and insights about Diverticulosis of the Sigmoid Colon
Primary ICD-10-CM Codes for diverticulosis in the sigmoid colon
Decision Criteria
clinical Criteria
- Diverticula present in sigmoid colon without bleeding or perforation
Clinical Validation Requirements
- CT scan showing diverticula in the sigmoid colon without inflammation
- Normal white blood cell count
Code-Specific Risks
- Misclassification if complications are present but not documented
Coding Notes
- Ensure documentation specifies 'sigmoid colon' to use this code.
K57.31 - Diverticulosis of large intestine with bleeding
Use when diverticulosis in the sigmoid colon is accompanied by bleeding.
Applicable To
- Sigmoid diverticulosis with hematochezia
Excludes
- Diverticulitis with bleeding (K57.21)
Clinical Validation Requirements
- Colonoscopy showing active bleeding from sigmoid diverticulum
- Documented hematochezia or melena
Coding Notes
Ensure bleeding is confirmed via endoscopy or imaging.
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 Diverticulosis of the Sigmoid Colon to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.30.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential for denied claims.
Mitigation Strategy
Ensure endoscopy reports are detailed., Verify bleeding source before coding.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Non-compliance with specificity requirements., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Always specify the location as 'sigmoid' to use K57.3x codes.
Impact
Audits may target unspecified locations in diverticulosis coding.
Mitigation Strategy
Always document the specific location as 'sigmoid'.
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 Diverticulosis of the Sigmoid Colon, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticulosis of the Sigmoid Colon
Use these documentation templates to ensure complete and accurate documentation for Diverticulosis of the Sigmoid Colon. These templates include all required elements for proper coding and billing.
Uncomplicated Diverticulosis
Specialty: GastroenterologyRequired Elements
- Location of diverticulosis
- Absence of complications
- Imaging findings
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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