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ICD-10 Guide
ICD-10 CodesK57.9

K57.9

Non-billable

Diverticular disease of intestine, part unspecified, without perforation or abscess

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

Code Description

ICD-10 K57.9 is a used to indicate a diagnosis of diverticular disease of intestine, part unspecified, without perforation or abscess.

Key Diagnostic Point:

Diverticular disease of the intestine, part unspecified, without perforation or abscess, refers to the presence of diverticula in the gastrointestinal tract, particularly in the colon, without any associated complications such as perforation or abscess formation. Clinically, patients may present with symptoms such as abdominal pain, bloating, changes in bowel habits, and occasionally, mild gastrointestinal bleeding. The diverticula are small pouches that form in the wall of the intestine, often due to increased pressure within the colon, typically associated with a low-fiber diet. Disease progression can lead to diverticulitis if inflammation occurs, but K57.9 specifically denotes the absence of such complications. Diagnostic considerations include a thorough patient history, physical examination, and imaging studies such as CT scans or colonoscopy to confirm the presence of diverticula and rule out other gastrointestinal conditions. It is essential to differentiate K57.9 from other related codes, such as K57.0 (diverticulitis of the colon) and K57.1 (diverticulitis of the small intestine), to ensure accurate coding and appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as it requires imaging and clinical assessment to confirm diagnosis.
  • Treatment complexity: Low to moderate, typically managed with dietary modifications and outpatient care.
  • Documentation requirements: Requires clear documentation of symptoms, diagnostic tests, and treatment plans.
  • Coding specificity: Moderate, as it is important to specify the absence of complications.

Audit Risk Factors

  • Common coding errors: Misclassification with diverticulitis codes.
  • Documentation gaps: Incomplete patient history or lack of imaging results.
  • Billing challenges: Potential denials if documentation does not clearly support 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Diverticular disease is prevalent in the aging population, impacting healthcare utilization patterns significantly. It is associated with increased visits to primary care and gastroenterology specialists, as well as potential hospitalizations if complications arise. Understanding K57.9 is crucial for quality measures in managing gastrointestinal health, as it helps in tracking the incidence of diverticular disease and its management in the population, ultimately influencing public health strategies.

ICD-9 vs ICD-10

Diverticular disease is prevalent in the aging population, impacting healthcare utilization patterns significantly. It is associated with increased visits to primary care and gastroenterology specialists, as well as potential hospitalizations if complications arise. Understanding K57.9 is crucial for quality measures in managing gastrointestinal health, as it helps in tracking the incidence of diverticular disease and its management in the population, ultimately influencing public health strategies.

Reimbursement & Billing Impact

Reimbursement considerations may vary by payer, and it is essential to check for specific guidelines. Common denials may arise from insufficient documentation or incorrect coding, particularly if the patient has a history of diverticulitis. Best practices include maintaining thorough records of patient encounters and ensuring that all relevant clinical information is captured in the documentation.

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 K57.9?

K57.9 covers diverticular disease of the intestine without complications. This includes the presence of diverticula in the colon or small intestine without any signs of diverticulitis, perforation, or abscess.

When should K57.9 be used instead of related codes?

K57.9 should be used when the patient has diverticular disease confirmed by imaging but does not exhibit any acute complications such as diverticulitis or abscess. It is crucial to differentiate based on clinical findings and diagnostic results.

What documentation supports K57.9?

Documentation should include a detailed patient history, physical examination findings, imaging results confirming the presence of diverticula, and any treatment plans or dietary recommendations made by the healthcare provider.