2024 ICD-10-CM Diagnosis Code K57.21

Diverticulitis of large intestine with perforation and abscess with bleeding

ICD-10-CM Code:
K57.21
ICD-10 Code for:
Dvtrcli of lg int w perforation and abscess w bleeding
Is Billable?
Yes - Valid for Submission
Chronic Condition Indicator: [1]
Chronic
Code Navigator:

Code Classification

  • Diseases of the digestive system
    (K00–K95)
    • Other diseases of intestines
      (K55-K64)
      • Diverticular disease of intestine
        (K57)

K57.21 is a billable diagnosis code used to specify a medical diagnosis of diverticulitis of large intestine with perforation and abscess with bleeding. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Clinical Classification

Clinical CategoryCCSR Category CodeInpatient Default CCSROutpatient Default CCSR
Diverticulosis and diverticulitisDIG013Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.
Gastrointestinal and biliary perforationDIG006N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.
Gastrointestinal hemorrhageDIG021N - Not default inpatient assignment for principal diagnosis or first-listed diagnosis.N - Not default outpatient assignment for principal diagnosis or first-listed diagnosis.

Convert K57.21 to ICD-9-CM

  • ICD-9-CM Code: 562.13 - Dvrtcli colon w hmrhg
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.
  • ICD-9-CM Code: 569.5 - Intestinal abscess
    Combination Flag - Multiple codes are needed to describe the source diagnosis code. Correct coding should be done based on contextual judgment.

Patient Education


Abscess

An abscess is a pocket of pus. You can get an abscess almost anywhere in your body. When an area of your body becomes infected, your body's immune system tries to fight the infection. White blood cells go to the infected area, collect within the damaged tissue, and cause inflammation. During this process, pus forms. Pus is a mixture of living and dead white blood cells, germs, and dead tissue.

Bacteria, viruses, parasites and swallowed objects can all lead to abscesses. Skin abscesses are easy to detect. They are red, raised and painful. Abscesses inside your body may not be obvious and can damage organs, including the brain, lungs and others. Treatments include drainage and antibiotics.


[Learn More in MedlinePlus]

Diverticulosis and Diverticulitis

What is diverticulosis?

Diverticula are small pouches, or sacs, that bulge outward through weak spots in your colon. They mostly form in the lower part of the colon. Diverticulosis is a condition in which you have these pouches. Most people who have diverticulosis do not have symptoms or problems. But sometimes the pouches can cause symptoms or become inflamed.

What is diverticulitis?

Diverticulitis is the name for the condition you have when one or more of the pouches get inflamed. Diverticulitis may come on suddenly. It can sometimes cause serious health problems.

What is diverticular disease?

Diverticular disease is a condition that happens when the pouches cause:

  • Chronic (long-term) symptoms
  • Diverticular bleeding
  • Diverticulitis or diverticulitis complications

What causes diverticulosis and diverticulitis?

Researchers aren't sure what causes diverticulosis and diverticulitis. They think certain factors may play a role in causing or increasing the risk for these conditions, including:

  • Your genetics. Certain genes may make some people more likely to develop the conditions.
  • Lifestyle factors such as:
    • Diets low in fiber and high in red meat
    • Lack of physical activity
    • Taking certain medicines, such as nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids
    • Having obesity
    • Smoking

Researchers are also looking at other possible factors that may play a role in these conditions. Those factors include bacteria or stool (poop) getting caught in a pouch in your colon and changes in the microbiome in the intestines. Your microbiome is made up of the bacteria and other organisms in your intestines.

Who is more likely to develop diverticulosis and diverticulitis?

Diverticulosis is common, especially as people age. More than one-third of U.S. adults between the ages of 50 and 59 have diverticulosis. More than two-thirds who are over age 80 have it. Most of those people will not have symptoms or problems. But some of them will develop diverticulitis.

What are the symptoms of diverticulosis and diverticulitis?

Diverticulosis usually doesn't cause symptoms. But some people can have chronic symptoms such as:

  • Bloating
  • Constipation or diarrhea
  • Cramping or painin the lower abdomen (belly)

Diverticulitis may cause acute symptoms such as:

  • Abdominal pain, most often in the lower left side of your abdomen
  • Constipation or diarrhea
  • Fevers and chills
  • Nausea or vomiting

The pain caused by diverticulitis is usually severe and comes on suddenly. Less often, the pain may be mild and worsen over several days.

What other problems can diverticulosis and diverticulitis cause?

Some people with diverticulosis and diverticulitis may develop serious health problems (complications). Diverticular bleeding happens when a small blood vessel within the wall of a pouch bursts. The bleeding may be severe and sometimes even life-threatening.

People with diverticulitis can also develop serious problems such as:

  • Abscess, a painful, swollen, pus-filled area caused by infection
  • Fistula, an abnormal opening or passage between the colon and another part of the body, such as the bladder or vagina
  • Intestinal obstruction, a partial or total blockage that keeps food, fluids, air, or stool from moving through your intestines
  • Perforation, or a hole, in your colon
  • Peritonitis, an infection of the lining of the abdominal cavity

How are diverticulosis and diverticulitis diagnosed?

Diverticulosis may be found when your health care provider is doing tests for another reason. Diverticulitis is usually found when you are having an acute attack.

To make a diagnosis, your provider will review your medical history, do a physical exam, and order tests. The tests may include:

  • Blood tests
  • Stool tests
  • Imaging tests such as CT scan, ultrasound, or MRI
  • Colonoscopy

What are the treatments for diverticulosis and diverticulitis?

f your diverticulosis is causing chronic symptoms, your provider may recommend:

  • High-fiber foods or fiber supplements
  • Antibiotics
  • Medicines to reduce inflammation
  • Probiotics

If you have diverticulitis without complications, your provider may recommend treatment at home. However, you probably need treatment in the hospital if you have severe diverticulitis, diverticulitis with complications, or a high risk for complications.

Treatments for diverticulitis may include:

  • Antibiotics, except for very mild cases.
  • A clear liquid diet for a short time to rest the colon. Your provider may suggest slowly adding solid foods to your diet as your symptoms improve.
  • Medicines for pain. This is usually acetaminophen instead of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs may increase the chance of diverticulitis complications.
  • Antispasmodic medicines to relieve spasms.

If your diverticulitis doesn't improve with treatment or if it causes complications, you may need surgery to remove part of your colon.

Can diverticulitis be prevented?

Your provider may recommend lifestyle changes to prevent diverticulitis:

  • Eating a diet high in fiber and low in red meat
  • Being physically active on a regular basis
  • Not smoking (and quitting smoking if you are a smoker)
  • Reaching and maintaining a healthy weight

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[Learn More in MedlinePlus]

Gastrointestinal Bleeding

Your digestive or gastrointestinal (GI) tract includes the esophagus, stomach, small intestine, large intestine or colon, rectum, and anus. Bleeding can come from any of these areas. The amount of bleeding can be so small that only a lab test can find it.

Signs of bleeding in the digestive tract depend where it is and how much bleeding there is.

Signs of bleeding in the upper digestive tract include:

  • Bright red blood in vomit
  • Vomit that looks like coffee grounds
  • Black or tarry stool
  • Dark blood mixed with stool

Signs of bleeding in the lower digestive tract include:

  • Black or tarry stool
  • Dark blood mixed with stool
  • Stool mixed or coated with bright red blood

GI bleeding is not a disease, but a symptom of a disease. There are many possible causes of GI bleeding, including hemorrhoids, peptic ulcers, tears or inflammation in the esophagus, diverticulosis and diverticulitis, ulcerative colitis and Crohn's disease, colonic polyps, or cancer in the colon, stomach or esophagus.

The test used most often to look for the cause of GI bleeding is called endoscopy. It uses a flexible instrument inserted through the mouth or rectum to view the inside of the GI tract. A type of endoscopy called colonoscopy looks at the large intestine.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Chronic - a chronic condition code indicates a condition lasting 12 months or longer and its effect on the patient based on one or both of the following criteria:

  • The condition results in the need for ongoing intervention with medical products,treatment, services, and special equipment
  • The condition places limitations on self-care, independent living, and social interactions.