2025 ICD-10-CM code K57.0
(Active) Effective Date: N/A Diseases of the digestive system - Other diseases of intestines (K55-K64) Diseases of the digestive system (K00-K95) Feed
Diverticulitis of small intestine with perforation and abscess.
Medical necessity is established by the presence of signs and symptoms consistent with diverticulitis, along with imaging confirmation of the diagnosis. Perforation and abscess formation represent serious complications that often require immediate medical intervention, including hospitalization, intravenous antibiotics, and possibly surgery.
The physician is responsible for diagnosing and managing the patient's condition, which may include ordering imaging studies (CT scan), prescribing antibiotics, and possibly consulting with a surgeon for potential drainage or surgical intervention.
In simple words: This code signifies inflammation of small pouches (diverticula) in your small intestine, leading to a rupture (perforation) and a localized collection of pus (abscess).
Diverticulitis of small intestine with perforation and abscess. Includes: Diverticulitis of small intestine with peritonitis. Excludes1: diverticulitis of both small and large intestine with perforation and abscess (K57.4). Excludes2: certain conditions originating in the perinatal period (P04-P96), certain infectious and parasitic diseases (A00-B99), complications of pregnancy, childbirth and the puerperium (O00-O9A), congenital malformations, deformations and chromosomal abnormalities (Q00-Q99), endocrine, nutritional and metabolic diseases (E00-E88), injury, poisoning and certain other consequences of external causes (S00-T88), neoplasms (C00-D49), symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Example 1: A patient presents with severe abdominal pain, fever, and tenderness localized to the lower left quadrant. A CT scan reveals diverticulitis of the small intestine with both perforation and abscess formation., A patient with a history of diverticulosis experiences sudden, sharp abdominal pain followed by fever and chills. Imaging confirms small intestinal diverticulitis with perforation and a localized abscess., During a surgical exploration for suspected appendicitis, the surgeon discovers perforated diverticulitis of the small intestine with an associated abscess. The appendix is normal.
Documentation should include details of the patient's symptoms (abdominal pain, fever, nausea, vomiting), physical examination findings (tenderness, guarding), imaging results (CT scan confirming diverticulitis, perforation, and abscess), and laboratory findings (elevated white blood cell count). The type, site, and complications related to the diverticulitis should be clearly documented.
- Specialties:Gastroenterology, General Surgery
- Place of Service:Inpatient Hospital, Emergency Room - Hospital