ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesK57.1

K57.1

Non-billable

Diverticular disease of small intestine without perforation or abscess

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K57.1 is a used to indicate a diagnosis of diverticular disease of small intestine without perforation or abscess.

Key Diagnostic Point:

Diverticular disease of the small intestine without perforation or abscess is characterized by the presence of diverticula, which are small pouches that can form in the walls of the small intestine. Clinically, patients may present with symptoms such as abdominal pain, bloating, and changes in bowel habits, although some may be asymptomatic. The anatomy involved includes the small intestine, particularly the jejunum and ileum, where diverticula can develop due to increased intraluminal pressure and weakened bowel wall. Disease progression can lead to complications such as diverticulitis, though in this case, the absence of perforation or abscess indicates a less severe form of the disease. Diagnostic considerations include imaging studies such as CT scans or ultrasounds, which can help visualize diverticula and rule out other gastrointestinal conditions. A thorough patient history and physical examination are also essential for accurate diagnosis and management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as symptoms can overlap with other gastrointestinal disorders.
  • Treatment complexity: Generally low, but may require dietary modifications and monitoring.
  • Documentation requirements: Requires detailed clinical documentation to support diagnosis.
  • Coding specificity: Moderate, as it is important to differentiate from other diverticular diseases.

Audit Risk Factors

  • Common coding errors: Misclassification of diverticular disease severity.
  • Documentation gaps: Incomplete patient history or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Primary Care

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Diverticular disease of the small intestine, while less common than colonic diverticular disease, still poses significant clinical challenges. It affects a notable portion of the population, particularly older adults, and can lead to increased healthcare utilization due to complications. Understanding this condition is crucial for improving patient outcomes and aligning with quality measures aimed at managing gastrointestinal disorders effectively.

ICD-9 vs ICD-10

Diverticular disease of the small intestine, while less common than colonic diverticular disease, still poses significant clinical challenges. It affects a notable portion of the population, particularly older adults, and can lead to increased healthcare utilization due to complications. Understanding this condition is crucial for improving patient outcomes and aligning with quality measures aimed at managing gastrointestinal disorders effectively.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical evidence and that any treatments or interventions are appropriately coded. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity. Best practices include maintaining clear and comprehensive records of patient encounters, diagnostic tests, and treatment plans to facilitate smooth billing processes.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K57.1?

K57.1 covers diverticular disease of the small intestine that is not complicated by perforation or abscess. It includes cases where diverticula are present but do not lead to acute diverticulitis or other severe complications.

When should K57.1 be used instead of related codes?

K57.1 should be used when the patient has diverticular disease specifically in the small intestine without any complications such as perforation or abscess. If complications are present, other codes such as K57.2 or K57.3 should be considered.

What documentation supports K57.1?

Documentation should include a detailed clinical history, physical examination findings, imaging results confirming the presence of diverticula, and any relevant laboratory tests that support the diagnosis of diverticular disease without complications.