ICD-10 Coding for Diverticulosis(K57.30, K57.31)
Complete ICD-10-CM coding and documentation guide for Diverticulosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Diverticulosis
K57.30-K57.92Primary Range
Diverticular disease of intestine
This range includes codes for diverticulosis with and without complications, specifying location and presence of bleeding.
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 without bleeding | Use when diverticulosis is found incidentally without symptoms or complications. |
|
| K57.31 | Diverticulosis of large intestine without perforation or abscess with bleeding | Use when bleeding is confirmed to be from diverticula. |
|
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 with bleeding
Essential facts and insights about Diverticulosis
Primary ICD-10-CM Codes for diverticulosis
Decision Criteria
clinical Criteria
- Diverticula present without symptoms
Applicable To
- Asymptomatic diverticulosis
Excludes
- Diverticulitis (K57.32)
Clinical Validation Requirements
- Colonoscopy showing diverticula
- Absence of symptoms or complications
Code-Specific Risks
- Misclassification if symptoms are present
Coding Notes
- Ensure documentation specifies absence of symptoms or complications.
K57.31 - Diverticulosis of large intestine without perforation or abscess with bleeding
Use when bleeding is confirmed to be from diverticula.
Applicable To
- Diverticular bleeding
Excludes
- Bleeding from other sources
Clinical Validation Requirements
- Colonoscopy confirming diverticular bleed
- Hemoglobin levels indicating anemia
Coding Notes
Documentation must confirm bleeding source.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Diverticulosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.30.
Impact
Clinical: Mismanagement of patient care, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always confirm bleeding source with diagnostics, Document findings in patient records
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Ensure documentation specifies presence or absence of inflammation.
Impact
Risk of audits if bleeding is not properly documented.
Mitigation Strategy
Ensure all bleeding is confirmed and documented with diagnostics.
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, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Diverticulosis
Use these documentation templates to ensure complete and accurate documentation for Diverticulosis. These templates include all required elements for proper coding and billing.
Diverticulosis with bleeding
Specialty: GastroenterologyRequired Elements
- Location of diverticula
- Presence of bleeding
- Diagnostic confirmation
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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