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2025 ICD-10-CM code K57.4

Diverticulitis of both small and large intestine with perforation and abscess.

Code also if applicable, peritonitis (K65.-).

Medical necessity for procedures related to K57.4 (e.g., abscess drainage, bowel resection) is established by the presence of perforation, abscess, and associated complications.The documentation must clearly support the need for the intervention based on the patient's clinical condition and imaging findings.

Clinicians diagnosing and managing K57.4 are responsible for confirming the presence of diverticulitis with perforation and abscess in both the small and large intestines through appropriate diagnostic imaging (CT scans) and potentially other investigations. Treatment may involve antibiotics, drainage of the abscess (percutaneously or surgically), and potentially bowel resection in severe cases.Managing potential complications such as peritonitis, sepsis, and fistula formation is also crucial.

In simple words: This condition involves inflamed pouches in both the small and large intestines, with holes that have formed, leading to a pocket of infection.

This code represents a condition where diverticula (small pouches) in both the small and large intestines have become inflamed (diverticulitis) and have developed perforations (holes) leading to the formation of an abscess (a collection of pus).

Example 1: A patient presents with severe abdominal pain, fever, and elevated white blood cell count. A CT scan reveals diverticulitis with perforation and abscess formation in both the small and large intestines., A patient with known diverticulosis experiences a sudden worsening of abdominal pain, distension, and signs of sepsis. Imaging confirms diverticulitis with perforation and abscess in multiple segments of the small and large bowel., During a surgical exploration for suspected appendicitis, the surgeon discovers perforated diverticulitis with abscess formation affecting both the small and large intestines.

Documentation should include imaging reports (CT scans) confirming the diagnosis, details about the location and extent of the diverticulitis, presence of perforation and abscess, laboratory results indicating infection (e.g., elevated white blood cell count), and any procedures performed (e.g., abscess drainage, bowel resection).

** Excludes1: congenital diverticulum of intestine (Q43.8), Meckel's diverticulum (Q43.0). Excludes2: diverticulum of appendix (K38.2)

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