2025 ICD-10-CM code K57.5
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Diverticular disease of intestine Diseases of the digestive system (K00-K95) Feed
Diverticular disease affecting both the small and large intestines, without perforation or abscess formation.
Modifiers may be applicable depending on the circumstances of the encounter and any procedures performed.
Medical necessity for procedures related to K57.5, such as colonoscopy, would typically be established by the presence of symptoms or risk factors for complications.Routine screening colonoscopies may be medically necessary depending on the patient's age and family history.
The clinical responsibility for managing a patient with K57.5 would typically fall upon a gastroenterologist.Depending on the severity and complications, a surgeon might be involved.Primary care physicians often manage uncomplicated cases.
In simple words: This code means you have small pouches in the walls of both your small and large intestines.These pouches haven't burst or become infected.
K57.5, Diverticular disease of both small and large intestine without perforation or abscess, refers to the presence of multiple diverticula (small pouches or sacs) in the walls of both the small and large intestines.This diagnosis excludes cases with perforation (rupture) or abscess (a collection of pus) formation.The condition may present as diverticulosis (presence of diverticula without inflammation) or diverticulitis (inflammation of the diverticula).
Example 1: A 60-year-old patient presents with intermittent lower abdominal cramping and discomfort. Colonoscopy reveals multiple diverticula in both the small and large intestines without evidence of inflammation, perforation, or abscess., A 72-year-old patient experiences recurrent episodes of mild lower abdominal pain and constipation. Imaging studies show diverticulosis in both the small and large intestines, and the patient is asymptomatic between episodes., A 55-year-old patient undergoes a routine colonoscopy which incidentally reveals asymptomatic diverticula in both the small and large intestine.There is no inflammation or other complications.
Complete medical history, including symptoms, physical examination findings, and results of diagnostic imaging (e.g., colonoscopy, CT scan) are essential.Documentation should specify the location and number of diverticula and explicitly rule out perforation and abscess formation.
** The presence of bleeding should be further specified using the appropriate 5th digit (e.g., K57.51 for bleeding).
- Payment Status: Active
- Modifier TC rule: Not applicable to this diagnosis code.
- Specialties:Gastroenterology, General Surgery, Internal Medicine
- Place of Service:Office, Hospital (Inpatient or Outpatient), Ambulatory Surgical Center