ICD-10 Coding for Sigmoid Diverticulosis(K57.30, K57.31)
Complete ICD-10-CM coding and documentation guide for Sigmoid Diverticulosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Sigmoid Diverticulosis
K57.30-K57.31Primary Range
Diverticulosis of large intestine
These codes are used for diverticulosis of the large intestine, including the sigmoid colon, without and with 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 | Use when diverticulosis is present in the sigmoid colon without bleeding or complications. |
|
| K57.31 | Diverticulosis of large intestine with bleeding | Use when diverticulosis is present in the sigmoid colon with documented 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 sigmoid diverticulosis
Essential facts and insights about Sigmoid Diverticulosis
Primary ICD-10-CM Codes for sigmoid diverticulosis
Decision Criteria
clinical Criteria
- Absence of inflammation or bleeding in imaging and endoscopy
Applicable To
- Sigmoid diverticulosis without bleeding
Clinical Validation Requirements
- CT imaging showing diverticula without inflammation
- Colonoscopy confirming non-inflamed diverticula
Code-Specific Risks
- Confusing diverticulosis with diverticulitis
Coding Notes
- Ensure documentation specifies 'diverticulosis' and location in the sigmoid colon.
K57.31 - Diverticulosis of large intestine with bleeding
Use when diverticulosis is present in the sigmoid colon with documented bleeding.
Applicable To
- Sigmoid diverticulosis with bleeding
Excludes
- Diverticulitis with bleeding (K57.33)
Clinical Validation Requirements
- Documentation of bleeding, such as hematochezia or positive fecal occult blood test
Coding Notes
Ensure bleeding is confirmed through clinical documentation.
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 Sigmoid 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: Misrepresents patient follow-up needs., Regulatory: Non-compliance with coding guidelines., Financial: Incorrect billing for follow-up visits.
Mitigation Strategy
Educate staff on chronic condition coding rules., Review coding guidelines regularly.
Impact
Reimbursement: Incorrect DRG assignment can affect reimbursement., Compliance: Misclassification can lead to compliance issues., Data Quality: Affects accuracy of clinical data.
Mitigation Strategy
Verify documentation for signs of inflammation or infection before coding.
Impact
Potential for coding errors due to similar terminology.
Mitigation Strategy
Regular training and audits of clinical documentation.
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 Sigmoid Diverticulosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Sigmoid Diverticulosis
Use these documentation templates to ensure complete and accurate documentation for Sigmoid Diverticulosis. These templates include all required elements for proper coding and billing.
Routine colonoscopy revealing diverticulosis
Specialty: GastroenterologyRequired Elements
- Patient history
- Colonoscopy findings
- Absence of complications
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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