ICD-10 Coding for Perforated Bowel(K57.20, K63.1)
Complete ICD-10-CM coding and documentation guide for Perforated Bowel. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Perforated Bowel
K57-K63Primary Range
Diseases of the intestines
Includes codes for diverticulitis with perforation and non-traumatic intestinal perforation.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K57.20 | Diverticulitis of large intestine with perforation and abscess, without bleeding | Use when diverticulitis is the confirmed cause of perforation with abscess formation. |
|
| K63.1 | Perforation of intestine (nontraumatic) | Use when the perforation is not due to diverticulitis or other specified conditions. |
|
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 perforated bowel
Essential facts and insights about Perforated Bowel
Primary ICD-10-CM Codes for perforated bowel
Decision Criteria
clinical Criteria
- Confirmed diverticulitis with imaging evidence of perforation and abscess
Applicable To
- Perforated diverticulitis of large intestine with abscess
Excludes
- Diverticulitis with bleeding
Clinical Validation Requirements
- CT findings of perforation and abscess
- Documented diagnosis of diverticulitis
Code-Specific Risks
- Misidentifying the cause of perforation
Coding Notes
- Ensure documentation specifies the presence of an abscess and the absence of bleeding.
K63.1 - Perforation of intestine (nontraumatic)
Use when the perforation is not due to diverticulitis or other specified conditions.
Applicable To
- Nontraumatic perforation of intestine
Excludes
- Traumatic perforation
Clinical Validation Requirements
- Imaging showing perforation without specific cause
Coding Notes
Ensure no specific cause is documented before using this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Peritoneal abscess
K65.1Differential 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 Perforated Bowel to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K57.20.
Impact
Clinical: Inadequate treatment planning, Regulatory: Potential audit issues, Financial: Missed reimbursement opportunities
Mitigation Strategy
Review imaging reports thoroughly, Ensure detailed operative notes
Impact
Reimbursement: Incorrect DRG assignment leading to potential reimbursement issues., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify the cause of perforation and use K57.20 if diverticulitis is confirmed.
Impact
Using K63.1 as primary when diverticulitis is the cause
Mitigation Strategy
Educate coders on proper sequencing rules
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 Perforated Bowel, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Perforated Bowel
Use these documentation templates to ensure complete and accurate documentation for Perforated Bowel. These templates include all required elements for proper coding and billing.
Acute perforated diverticulitis
Specialty: GastroenterologyRequired Elements
- Chief complaint
- Imaging findings
- Diagnosis
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Perforated Bowel? Ask your questions below.