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ICD-10 Guide
ICD-10 CodesK63.0

K63.0

Billable

Abscess of intestine

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

Code Description

ICD-10 K63.0 is a billable code used to indicate a diagnosis of abscess of intestine.

Key Diagnostic Point:

An abscess of the intestine is a localized collection of pus within the intestinal wall, often resulting from infection, inflammation, or obstruction. Clinically, patients may present with abdominal pain, fever, and signs of systemic infection. The anatomy involved typically includes the small or large intestine, where the abscess can develop due to conditions such as diverticulitis, Crohn's disease, or perforation. Disease progression can lead to complications such as peritonitis or sepsis if not addressed promptly. Diagnostic considerations include imaging studies like CT scans or ultrasounds, which can reveal the presence of an abscess, along with laboratory tests to assess infection markers. Early identification and treatment are crucial to prevent severe outcomes and may involve antibiotics and surgical intervention to drain the abscess.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation
  • Treatment complexity: May involve surgical procedures and multidisciplinary care
  • Documentation requirements: Detailed clinical notes and imaging reports needed
  • Coding specificity: Requires accurate identification of the abscess location and underlying cause

Audit Risk Factors

  • Common coding errors: Misidentification of abscess location or cause
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports
  • Billing challenges: Denials due to insufficient documentation or incorrect coding

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

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K63.0 lies in its potential complications, including sepsis and peritonitis, which can lead to increased healthcare utilization and hospital admissions. Understanding the epidemiology of intestinal abscesses can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely diagnosis and treatment of intestinal abscesses are crucial for improving patient outcomes and reducing healthcare costs.

ICD-9 vs ICD-10

The clinical significance of K63.0 lies in its potential complications, including sepsis and peritonitis, which can lead to increased healthcare utilization and hospital admissions. Understanding the epidemiology of intestinal abscesses can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely diagnosis and treatment of intestinal abscesses are crucial for improving patient outcomes and reducing healthcare costs.

Reimbursement & Billing Impact

The clinical significance of K63.0 lies in its potential complications, including sepsis and peritonitis, which can lead to increased healthcare utilization and hospital admissions. Understanding the epidemiology of intestinal abscesses can help healthcare providers identify at-risk populations and implement preventive measures. Quality measures related to timely diagnosis and treatment of intestinal abscesses are crucial for improving patient outcomes and reducing healthcare costs.

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 K63.0?

K63.0 covers abscesses of the intestine, which may arise from conditions such as diverticulitis, Crohn's disease, or post-surgical complications. It is essential to document the underlying cause and specific location of the abscess for accurate coding.

When should K63.0 be used instead of related codes?

K63.0 should be used when there is a confirmed diagnosis of an intestinal abscess. It is important to differentiate it from other gastrointestinal conditions, such as K63.1 (perforation of intestine) or K63.9 (unspecified disorder of intestine), based on clinical findings and imaging results.

What documentation supports K63.0?

Documentation for K63.0 should include clinical notes detailing the patient's symptoms, imaging studies confirming the presence of an abscess, laboratory results indicating infection, and any surgical reports if applicable. Comprehensive documentation is crucial for accurate coding and reimbursement.