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ICD-10 Guide
ICD-10 CodesK57.13

K57.13

Billable

Diverticulitis of small intestine without perforation or abscess with bleeding

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

Code Description

ICD-10 K57.13 is a billable code used to indicate a diagnosis of diverticulitis of small intestine without perforation or abscess with bleeding.

Key Diagnostic Point:

Diverticulitis of the small intestine without perforation or abscess with bleeding is a gastrointestinal condition characterized by inflammation of diverticula, which are small pouches that can form in the walls of the intestines. This condition typically presents with symptoms such as abdominal pain, fever, and changes in bowel habits, including diarrhea or constipation. The small intestine anatomy involved includes the duodenum, jejunum, and ileum, where diverticula may develop, although they are more commonly associated with the colon. Disease progression can lead to complications if not managed properly, including potential obstruction or recurrent episodes of diverticulitis. Diagnostic considerations include imaging studies such as CT scans, which can help visualize inflammation and rule out complications like perforation or abscess formation. Laboratory tests may also be performed to assess for infection or bleeding, which is a key feature of this diagnosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical evaluation to confirm
  • Treatment complexity: May involve dietary changes, antibiotics, or surgery in severe cases
  • Documentation requirements: Detailed clinical notes and imaging results needed
  • Coding specificity: Must differentiate from other types of diverticulitis and gastrointestinal conditions

Audit Risk Factors

  • Common coding errors: Misclassification of diverticulitis type or severity
  • Documentation gaps: Incomplete clinical notes regarding symptoms and treatment
  • Billing challenges: Denials due to lack of supporting documentation for bleeding

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

Diverticulitis of the small intestine has significant clinical implications, as it can lead to increased healthcare utilization due to hospitalizations and surgical interventions. The condition affects a substantial portion of the population, particularly older adults, and can impact quality of life. Understanding its epidemiology is crucial for developing preventive strategies and improving patient outcomes.

ICD-9 vs ICD-10

Diverticulitis of the small intestine has significant clinical implications, as it can lead to increased healthcare utilization due to hospitalizations and surgical interventions. The condition affects a substantial portion of the population, particularly older adults, and can impact quality of life. Understanding its epidemiology is crucial for developing preventive strategies and improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and any associated procedures performed. Common denials may arise from insufficient documentation of the bleeding or failure to demonstrate the absence of complications. Best practices include thorough clinical notes, clear imaging reports, and ensuring that all relevant information is included in the claim submission.

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 K57.13?

K57.13 covers diverticulitis of the small intestine that is not complicated by perforation or abscess but includes cases where there is bleeding. It is essential to document the presence of diverticula and the inflammatory process.

When should K57.13 be used instead of related codes?

K57.13 should be used when diverticulitis is confirmed in the small intestine without complications such as perforation or abscess, and when there is evidence of bleeding. Related codes may apply if complications are present.

What documentation supports K57.13?

Documentation should include clinical findings, imaging results confirming diverticulitis, details of bleeding, and treatment plans. Clear notes on the absence of perforation or abscess are crucial.