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2025 ICD-10-CM code K57

Diverticular disease of the intestine, encompassing diverticulitis with or without perforation and abscess, and conditions without these complications.

Appropriate coding depends on the location of the diverticula (small or large intestine) and the presence of complications (perforation, abscess).The most specific code should be used.

Modifiers may be applicable depending on the circumstances of the service provided.Consultation with coding guidelines is recommended.

Medical necessity is established by the presence of symptoms consistent with diverticular disease, confirmed by appropriate diagnostic testing, and the need for treatment, which may include medical management (antibiotics, dietary changes), minimally invasive procedures, or surgery, depending on the severity and complications.

Gastroenterologists, surgeons, and primary care physicians may be involved depending on the severity and complexity of the diverticular disease.

IMPORTANT:Additional codes may be required to specify the location (small intestine, large intestine, or both) and the presence or absence of complications like perforation and abscess.The codes K57.0, K57.1, K57.8, and K57.9 provide more specific information.

In simple words: This code describes problems with small pouches that can form in the intestines.Sometimes these pouches get infected (diverticulitis), which may lead to a hole (perforation) or an infection that collects pus (abscess). This code covers the different possibilities, from simple pouches to more serious complications.

K57 encompasses diverticular disease of the intestine. This includes diverticulitis of the small intestine with or without perforation and abscess (K57.0, K57.1), and diverticular disease of the large intestine with or without perforation or abscess (K57.8, K57.9).The code specifies the presence or absence of complications such as perforation and abscess.Additional codes may be necessary to specify the location (small intestine, large intestine, or both) and other relevant details.

Example 1: A 60-year-old female presents with abdominal pain, fever, and nausea.A CT scan reveals diverticulitis of the sigmoid colon with an abscess.The physician codes K57.9 (Diverticular disease of large intestine without perforation or abscess) and adds an additional code for the abscess., A 72-year-old male experiences chronic lower abdominal discomfort. Colonoscopy confirms diverticular disease of the large intestine without any acute inflammation or complications.The code K57.9 is appropriate., A 45-year-old female is admitted to the hospital due to severe abdominal pain and fever.She is diagnosed with perforated diverticulitis of the small intestine and requires emergency surgery.Appropriate codes would include K57.0 (Diverticulitis of small intestine with perforation and abscess) along with surgical codes.

Detailed history of symptoms, physical examination findings, results of diagnostic tests such as colonoscopy, CT scan, or abdominal X-ray, and treatment details (medical management or surgical intervention).For cases with complications, thorough documentation of the abscess or perforation is critical.

** K57 excludes congenital diverticulum of the intestine (Q43.8), Meckel's diverticulum (Q43.0), and diverticulum of the appendix (K38.2).Always refer to the latest official ICD-10-CM coding guidelines for the most up-to-date information.

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