K68.12 — Psoas muscle abscess
K68.12 is a billable, specific ICD-10-CM code for psoas muscle abscess. It is valid for submission on a claim.
Other codes that can never be billed with K68.12
These codes carry an Excludes1 note pointing at K68.12. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K68.12 alone.
- K65Peritonitis
Risk adjustment
K68.12 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 78 Intestinal Obstruction/Perforation0.326 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
K68.12 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56766Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures
How K68.12 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 K68.12.
- Abscess›psoas muscle
Code history
K68.12 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share K68.1. If K68.12 is not quite right, the correct code is usually one of these.
Questions about K68.12
- Is K68.12 a billable ICD-10-CM code?
- Yes. K68.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K68.12 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of peritoneum and retroperitoneum (K65-K68).