K57.4 vs K63.1
K57.4 and K63.1 can never be reported together. ICD-10-CM declares them mutually exclusive with an Excludes1 note, meaning the two conditions cannot occur in the same patient — so exactly one of them is correct for any given encounter.
K57.4
Diverticulitis of both small and large intestine with perforation and abscess
Not billable
- Chapter 11
- Diseases of the digestive system
- Section
- K55-K64
K63.1
Perforation of intestine (nontraumatic)
Billable
- Chapter 11
- Diseases of the digestive system
- Section
- K55-K64
Use when the record says
- Perforation (nontraumatic) of rectum
Indexed under
- Perforation, perforated › bowel (nontraumatic) (of)
- Perforation, perforated › colon (nontraumatic) (of)
- Perforation, perforated › ileum (nontraumatic) (of)
- Perforation, perforated › intestine NEC (nontraumatic) (of)
- Perforation, perforated › jejunum, jejunal (nontraumatic) (of)
Excludes1 is not always absolute: where two conditions covered by the note are genuinely unrelated, CMS guidance permits reporting both. Document the reasoning rather than assuming it. More on Excludes1 vs Excludes2 · FY2027