Is K57.40 a billable ICD-10-CM code?

Yes. K57.40 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does K57.40 sit in the tabular list?

Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).

K57.40

K57.40 — Diverticulitis of both small and large intestine with perforation and abscess without bleeding

Billable / specific codeICD-10-CM

K57.40 is a billable, specific ICD-10-CM code for diverticulitis of both small and large intestine with perforation and abscess without bleeding. It is valid for submission on a claim.

Risk adjustment

K57.40 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

K57.40 is named in 8 Medicare coverage policies — 8 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55937Billing and Coding: Diagnostic Colonoscopy
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

How K57.40 is indexed

Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K57.40.

Perforation, perforated›diverticulum›large intestine›with›small intestine
Perforation, perforated›diverticulum›small intestine›with›large intestine
Rupture, ruptured›diverticulum›large intestine›with›small intestine
Rupture, ruptured›diverticulum›small intestine›with›large intestine
Abscess›with›diverticular disease›large intestine›with›small intestine
Abscess›with›diverticular disease›small intestine›with›large intestine
Peritonitis›with or following›diverticular disease›large intestine›with›small intestine
Peritonitis›with or following›diverticular disease›small intestine›with›large intestine
Diverticulitis›intestine›large›with›small intestine›with›abscess, perforation
Diverticulitis›intestine›small›with›large intestine›with›abscess, perforation

Related codes at this level

Codes that share K57.4. If K57.40 is not quite right, the correct code is usually one of these.

K57.41Diverticulitis of both small and large intestine with perforation and abscess with bleeding

Questions about K57.40

Is K57.40 a billable ICD-10-CM code?: Yes. K57.40 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K57.40 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).