ICD-10 Coding for Diverticulosis of the Colon(K57.30, K57.31, K57.32)
Complete ICD-10-CM coding and documentation guide for Diverticulosis of the 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 Colon
K57.30-K57.39Primary Range
Diverticular disease of intestine
This range includes codes for diverticulosis and diverticulitis of the large intestine, with and without complications.
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, abscess, or bleeding | Use when diverticulosis is confirmed without any complications such as bleeding or inflammation. |
|
| K57.31 | Diverticulosis of large intestine with bleeding | Use when diverticulosis is accompanied by active bleeding. |
|
| K57.32 | Diverticulitis of large intestine without perforation or abscess | Use when there is evidence of inflammation without complications like perforation. |
|
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 of colon
Essential facts and insights about Diverticulosis of the Colon
Primary ICD-10-CM Codes for diverticulosis of colon
Decision Criteria
clinical Criteria
- Absence of symptoms such as fever or elevated inflammatory markers
documentation Criteria
- Explicit mention of 'diverticulosis' without complications
Applicable To
- Asymptomatic diverticulosis
- Incidental finding on colonoscopy
Clinical Validation Requirements
- Colonoscopy or imaging report confirming diverticula
- Absence of fever, leukocytosis, or CT findings of inflammation
Code-Specific Risks
- Confusion with diverticulitis if inflammation is not ruled out
- Incorrect coding if complications are present but not documented
Coding Notes
- Ensure documentation specifies 'diverticulosis' and not 'diverticular disease' to avoid ambiguity.
K57.31 - Diverticulosis of large intestine with bleeding
Use when diverticulosis is accompanied by active bleeding.
Applicable To
- Diverticular hemorrhage
Excludes
- Diverticulitis with bleeding (K57.33)
Clinical Validation Requirements
- Documentation of hematochezia or rectal bleeding
- Endoscopic confirmation of bleeding diverticulum
Coding Notes
Ensure bleeding is documented and confirmed via appropriate diagnostic methods.
K57.32 - Diverticulitis of large intestine without perforation or abscess
Use when there is evidence of inflammation without complications like perforation.
Applicable To
- Acute diverticulitis
Excludes
- Diverticulosis without inflammation (K57.30)
Clinical Validation Requirements
- Presence of fever, leukocytosis, or elevated CRP
- CT findings of inflammation or pericolonic fat stranding
Coding Notes
Ensure inflammation is clearly documented to differentiate from uncomplicated diverticulosis.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Diverticulitis of large intestine without perforation or abscess
K57.32Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diverticulosis of the 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: Potential misdiagnosis of diverticulitis., Regulatory: Non-compliance with ICD-10 coding standards., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Educate providers on documentation specificity, Implement EHR prompts for clarification
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
Ensure documentation specifies absence of inflammation for diverticulosis.
Impact
Risk of audits due to non-specific coding.
Mitigation Strategy
Ensure detailed documentation specifying diverticulosis or diverticulitis.
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 Colon, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticulosis of the Colon
Use these documentation templates to ensure complete and accurate documentation for Diverticulosis of the Colon. These templates include all required elements for proper coding and billing.
Routine colonoscopy finding
Specialty: GastroenterologyRequired Elements
- Location of diverticula
- Absence of complications
- Colonoscopy findings
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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