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ICD-10 Guide
ICD-10 CodesK68.19

K68.19

Billable

Other retroperitoneal abscess

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

Code Description

ICD-10 K68.19 is a billable code used to indicate a diagnosis of other retroperitoneal abscess.

Key Diagnostic Point:

K68.19 refers to other retroperitoneal abscesses, which are localized collections of pus that occur in the retroperitoneal space, an area located behind the peritoneum that houses vital structures such as the kidneys, ureters, aorta, and inferior vena cava. Clinical presentation may include abdominal pain, fever, and signs of systemic infection. The abscess can arise from various etiologies, including perforation of adjacent organs, trauma, or hematogenous spread of infection. Disease progression can lead to severe complications if not addressed promptly, including sepsis or organ dysfunction. Diagnostic considerations involve imaging studies such as CT scans or ultrasounds to confirm the presence and extent of the abscess. Laboratory tests may reveal leukocytosis and elevated inflammatory markers. Early recognition and intervention are crucial to prevent morbidity and mortality associated with this condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and clinical correlation for accurate diagnosis.
  • Treatment complexity: May necessitate surgical intervention or drainage procedures.
  • Documentation requirements: Detailed clinical notes and imaging reports are essential.
  • Coding specificity: Requires precise coding to differentiate from other abdominal abscesses.

Audit Risk Factors

  • Common coding errors: Misclassification with other abdominal abscess codes.
  • Documentation gaps: Insufficient detail regarding the abscess's location and etiology.
  • Billing challenges: Potential for denials if documentation does not support the diagnosis.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K68.19 lies in its potential to lead to severe complications if not diagnosed and treated promptly. Population health impact includes increased healthcare utilization due to hospital admissions and surgical interventions. Quality measures may focus on timely diagnosis and treatment of retroperitoneal abscesses to reduce morbidity. Understanding epidemiological patterns can help in identifying at-risk populations and improving preventive care strategies.

ICD-9 vs ICD-10

The clinical significance of K68.19 lies in its potential to lead to severe complications if not diagnosed and treated promptly. Population health impact includes increased healthcare utilization due to hospital admissions and surgical interventions. Quality measures may focus on timely diagnosis and treatment of retroperitoneal abscesses to reduce morbidity. Understanding epidemiological patterns can help in identifying at-risk populations and improving preventive care strategies.

Reimbursement & Billing Impact

The clinical significance of K68.19 lies in its potential to lead to severe complications if not diagnosed and treated promptly. Population health impact includes increased healthcare utilization due to hospital admissions and surgical interventions. Quality measures may focus on timely diagnosis and treatment of retroperitoneal abscesses to reduce morbidity. Understanding epidemiological patterns can help in identifying at-risk populations and improving preventive care strategies.

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 K68.19?

K68.19 encompasses various types of retroperitoneal abscesses not classified elsewhere, including those resulting from infections, trauma, or complications from surgical procedures. It is essential to document the underlying cause to support the diagnosis.

When should K68.19 be used instead of related codes?

K68.19 should be used when the abscess is specifically located in the retroperitoneal space and does not fit the criteria for more specific codes. It is crucial to differentiate based on the abscess's location and etiology.

What documentation supports K68.19?

Documentation should include clinical findings, imaging results confirming the abscess's presence, laboratory tests indicating infection, and any relevant surgical notes if intervention is performed.