Learn about Acute Diverticulitis, also known as Sigmoid Diverticulitis, including clinical documentation, medical coding, and healthcare best practices. This resource covers Diverticular Disease with Inflammation diagnosis, symptoms, treatment, and management. Find information relevant for physicians, nurses, and other healthcare professionals seeking accurate and up-to-date information on Acute Diverticulitis.
Also known as
Diverticular disease of intestine
Covers diverticulitis, including sigmoid and with inflammation/abscess.
Diverticulitis of sigmoid colon
Specifically for sigmoid diverticulitis with or without perforation/abscess.
Diverticulitis of intestine, unspecified
For diverticulitis when the specific location isn't documented.
Other diseases of intestines
May be used for complications or manifestations not covered in K57.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the diverticulitis acute?
Yes
With perforation?
No
Do not code as acute diverticulitis. Consider K57.30, K57.31, K57.32, K57.33, K57.90, K57.91 based on documentation.
When to use each related code
| Description |
|---|
| Acute inflammation of intestinal pouches. |
| Painless diverticula without inflammation. |
| Chronic, recurring diverticular inflammation. |
Coding acute diverticulitis requires specifying uncomplicated, complicated, or with peritonitis for accurate reimbursement.
Documentation must clarify the diverticulitis location (e.g., sigmoid, colon) for proper code assignment and CDI.
Failing to document abscess, perforation, or obstruction leads to undercoding and lost revenue for complicated diverticulitis.
Q: What are the most effective evidence-based strategies for managing uncomplicated acute diverticulitis in outpatient settings?
A: Managing uncomplicated acute diverticulitis in an outpatient setting often involves a combination of strategies focused on bowel rest, infection control, and symptom management. Evidence-based guidelines suggest initiating a clear liquid diet for a few days to allow the bowel to rest, gradually reintroducing low-fiber foods as tolerated. Antibiotics, such as ciprofloxacin and metronidazole, or amoxicillin-clavulanate, are commonly prescribed for 7-10 days to address the underlying infection. Pain management can be achieved with over-the-counter analgesics like acetaminophen or ibuprofen. Close monitoring for worsening symptoms or complications, like abscess formation or perforation, is crucial. Patient education on dietary modifications, such as gradually increasing fiber intake after the acute episode subsides, is also vital for long-term management and prevention of recurrence. Consider implementing a standardized patient education protocol that addresses frequently asked questions regarding diet, activity, and follow-up care. Learn more about the role of probiotics and prebiotics in preventing future episodes.
Q: How can I differentiate between acute diverticulitis and other acute abdominal conditions like appendicitis or irritable bowel syndrome (IBS) based on clinical presentation and diagnostic testing in a primary care setting?
A: Differentiating acute diverticulitis from other acute abdominal conditions requires a careful assessment of clinical presentation and targeted diagnostic testing. While left lower quadrant pain is characteristic of diverticulitis, its presentation can overlap with conditions like appendicitis (typically right lower quadrant pain) or irritable bowel syndrome (IBS). Physical exam findings, such as localized tenderness, guarding, or rebound tenderness in the left lower quadrant, can suggest diverticulitis. However, imaging studies are crucial for definitive diagnosis. A CT scan with intravenous and oral contrast is the gold standard, revealing bowel wall thickening, pericolonic inflammation, and potential complications like abscesses. Blood tests, like a complete blood count (CBC), can reveal elevated white blood cells suggestive of infection but are not specific to diverticulitis. In contrast, IBS typically presents with chronic abdominal pain, altered bowel habits, and the absence of inflammatory markers. Explore how incorporating validated clinical decision rules, alongside patient history and physical exam findings, can enhance diagnostic accuracy and reduce unnecessary testing.
Patient presents with complaints consistent with acute diverticulitis, possibly sigmoid diverticulitis. Symptoms include left lower quadrant abdominal pain, localized tenderness, fever, nausea, and altered bowel habits such as constipation or diarrhea. The patient reports no history of diverticular bleeding or perforation. Physical examination reveals abdominal guarding and rebound tenderness in the LLQ. Differential diagnosis includes irritable bowel syndrome, appendicitis, inflammatory bowel disease, and pelvic inflammatory disease. Laboratory findings indicate leukocytosis with a left shift. A CT scan of the abdomen and pelvis with IV and oral contrast was ordered to evaluate for diverticular inflammation, abscess formation, and rule out other pathologies. Initial management includes bowel rest, intravenous fluids, and broad-spectrum antibiotics such as metronidazole and ciprofloxacin for treatment of diverticulitis. The patient's condition will be closely monitored for improvement. Surgical consultation will be considered if the patient fails to respond to conservative management, develops complications such as peritonitis or abscess, or exhibits signs of recurrent diverticulitis. Patient education provided regarding diverticulitis diet recommendations, including a high-fiber diet after the acute phase, and the importance of follow-up care. ICD-10 code K57.32 for uncomplicated diverticulitis of sigmoid colon is provisionally assigned, pending confirmation with imaging results. CPT codes for evaluation and management, laboratory services, and imaging will be documented accordingly. This documentation will be updated upon review of the CT scan findings and the patient's response to treatment.