Resolved Partial Colectomy with K57.20 Question

[LoganR_46098]

We billed BCBS for services rendered on 9/12/22 for the following CPT codes

44207 and 44213 with DX code K57.20 and our claim denied BCBS is saying per a big update in April per CMS coding guidelines K57.20 is inconsistent with CPT 44207. We have always used K57.20 with 44207 is this not a valid ICD 10 any longer or do we need to be adding an additional code?

 

[Alicia]

44207 - Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic anastomosis)
44213 - Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List separately in addition to primary procedure)
K57.20 - Diverticulitis of large intestine with perforation and abscess without bleeding

Diverticulitis with Intra-Abdominal Abscess​

question
When a patient is admitted with diverticulitis of the colon and an intra-abdominal abscess, is code K65.1, Peritoneal abscess, assigned along with code K57.20, Diverticulitis of large intestine with perforation and abscess without bleeding?
answer
Yes. Assign code K57.20, Diverticulitis of large intestine with perforation and abscess without bleeding, followed by K65.1, Peritoneal abscess, to further specify the location of the abscess.

This code assignment is supported by the “code also” note located under both code categories. The note under category K57, Diverticular disease of intestines, instructs the coding professional to code peritonitis if applicable, and the note under category K65, Peritonitis, instructs to code if applicable diverticular disease of intestine (K57-).
Ask the Editor: Diverticulitis with Intra-Abdominal Abscess. (2022, Issue 1). AHA Coding Clinic for ICD-10-CM and ICD-10-PCS. Retrieved from https://www.findacode.com/newslette...iculitis-intra-abdominal-abscess-I091023.html
New codes contained in this issue effective with discharges April 1, 2022. Other coding advice or code assignments contained in this issue effective with discharges March 18, 2022.
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