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ICD-10 Guide
ICD-10 CodesK68.11

K68.11

Billable

Postprocedural retroperitoneal abscess

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

Code Description

ICD-10 K68.11 is a billable code used to indicate a diagnosis of postprocedural retroperitoneal abscess.

Key Diagnostic Point:

Postprocedural retroperitoneal abscess is a localized collection of pus that occurs in the retroperitoneal space following a surgical procedure. The retroperitoneal space is anatomically defined as the area behind the peritoneum, which houses vital structures such as the kidneys, ureters, aorta, inferior vena cava, and parts of the gastrointestinal tract. Clinically, patients may present with abdominal pain, fever, and signs of systemic infection. The progression of a retroperitoneal abscess can vary; it may develop rapidly following invasive procedures such as appendectomy, colon surgery, or trauma, or it may arise more insidiously due to underlying conditions like pancreatitis or diverticulitis. Diagnosis typically involves imaging studies such as ultrasound or CT scans, which can reveal fluid collections indicative of an abscess. Laboratory tests may show leukocytosis or elevated inflammatory markers. Prompt identification and management are crucial to prevent complications such as sepsis or organ dysfunction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation to confirm abscess formation.
  • Treatment complexity: Management may involve antibiotics, drainage procedures, or surgical intervention.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential for accurate coding.
  • Coding specificity: Requires precise coding to differentiate from other types of abscesses.

Audit Risk Factors

  • Common coding errors: Misclassification of abscess type or location.
  • Documentation gaps: Insufficient clinical details to support the diagnosis.
  • Billing challenges: Potential for denials if documentation does not clearly indicate the postprocedural nature of the abscess.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: General Surgery

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

Postprocedural retroperitoneal abscesses can significantly impact patient outcomes, leading to increased morbidity and healthcare utilization. Early diagnosis and intervention are crucial to prevent complications such as sepsis, which can result in prolonged hospital stays and increased healthcare costs. Understanding the epidemiology of these abscesses can help healthcare providers implement preventive measures and improve quality of care for surgical patients.

ICD-9 vs ICD-10

Postprocedural retroperitoneal abscesses can significantly impact patient outcomes, leading to increased morbidity and healthcare utilization. Early diagnosis and intervention are crucial to prevent complications such as sepsis, which can result in prolonged hospital stays and increased healthcare costs. Understanding the epidemiology of these abscesses can help healthcare providers implement preventive measures and improve quality of care for surgical patients.

Reimbursement & Billing Impact

Postprocedural retroperitoneal abscesses can significantly impact patient outcomes, leading to increased morbidity and healthcare utilization. Early diagnosis and intervention are crucial to prevent complications such as sepsis, which can result in prolonged hospital stays and increased healthcare costs. Understanding the epidemiology of these abscesses can help healthcare providers implement preventive measures and improve quality of care for surgical patients.

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 K68.11?

K68.11 specifically covers abscesses that develop in the retroperitoneal space as a direct result of surgical procedures. This includes abscesses following surgeries on the gastrointestinal tract, kidneys, or other retroperitoneal structures.

When should K68.11 be used instead of related codes?

K68.11 should be used when the abscess is confirmed to be postprocedural and located in the retroperitoneal space. If the abscess is located in the peritoneal cavity or is not related to a surgical procedure, other codes should be considered.

What documentation supports K68.11?

Documentation should include operative reports detailing the procedure performed, imaging studies confirming the presence of the abscess, and clinical notes indicating the patient's symptoms and treatment plan.