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 CodesChapter 11: Diseases of the digestive systemK37

K37

Billable

Unspecified appendicitis

Chapter 11:Diseases of the digestive system

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

Code Description

ICD-10 K37 is a billable code used to indicate a diagnosis of unspecified appendicitis.

Key Diagnostic Point:

Unspecified appendicitis (K37) refers to an inflammatory condition of the appendix that is not further classified as acute or chronic. Clinically, patients may present with abdominal pain, typically localized in the right lower quadrant, nausea, vomiting, and fever. The anatomy involved includes the appendix, a small, tube-like structure attached to the cecum of the large intestine. Disease progression can vary; if untreated, appendicitis can lead to complications such as perforation, abscess formation, or peritonitis. Diagnostic considerations include a thorough clinical evaluation, imaging studies such as ultrasound or CT scans, and laboratory tests to assess for signs of infection or inflammation. The diagnosis of unspecified appendicitis is often made when the clinical presentation aligns with appendicitis but lacks definitive imaging or pathological confirmation of the type of appendicitis, necessitating careful clinical judgment and documentation to support the diagnosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires clinical evaluation and may involve imaging studies.
  • Treatment complexity: Surgical intervention (appendectomy) is often required, with postoperative care considerations.
  • Documentation requirements: Detailed documentation of symptoms, diagnostic tests, and clinical decision-making is essential.
  • Coding specificity: While K37 is specific for unspecified appendicitis, differentiating it from acute (K35) and chronic (K36) appendicitis is crucial.

Audit Risk Factors

  • Common coding errors: Misclassification of appendicitis type can lead to incorrect coding.
  • Documentation gaps: Incomplete clinical notes may result in denials or audits.
  • Billing challenges: Lack of clear documentation may lead to reimbursement issues.

Specialty Focus

Medical Specialties

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

Emergency Medicine

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 CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Unspecified appendicitis has significant clinical implications, as timely diagnosis and treatment are crucial to prevent complications such as perforation. In terms of population health, appendicitis is a common surgical emergency, affecting various demographics. Understanding the epidemiology of appendicitis can inform healthcare utilization patterns and quality measures aimed at improving outcomes for patients presenting with abdominal pain.

ICD-9 vs ICD-10

Unspecified appendicitis has significant clinical implications, as timely diagnosis and treatment are crucial to prevent complications such as perforation. In terms of population health, appendicitis is a common surgical emergency, affecting various demographics. Understanding the epidemiology of appendicitis can inform healthcare utilization patterns and quality measures aimed at improving outcomes for patients presenting with abdominal pain.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of surgical intervention, typically an appendectomy, and the associated postoperative care. Common denials may arise from insufficient documentation or failure to provide evidence of medical necessity. Best practices include thorough clinical notes, clear justification for the diagnosis, and adherence to coding guidelines to minimize audit risks and ensure appropriate reimbursement.

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 K37?

K37 covers cases of appendicitis where the type is not specified, including instances where the clinical presentation suggests appendicitis but lacks definitive imaging or pathological confirmation.

When should K37 be used instead of related codes?

K37 should be used when appendicitis is suspected but not definitively classified as acute or chronic, ensuring that the clinical documentation supports the diagnosis of unspecified appendicitis.

What documentation supports K37?

Documentation must include a detailed account of the patient's symptoms, clinical findings, results from imaging studies, and any laboratory tests that support the diagnosis of appendicitis.