ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 K35.30

Billable / Specific CC

Acute appendicitis with localized peritonitis, without perforation or gangrene

K35
Block
1
Synonyms
12
LCDs
2
Payer Policies
2
Linked CPTs

About ICD-10-CM K35.30

ICD-10-CM code K35.30 represents Acute appendicitis with localized peritonitis, without perforation or gangrene. This is a billable/specific code in the Digestive System chapter (block K35). The 2026 edition of ICD-10-CM K35.30 became effective on October 1, 2025.

Coding Tips for K35.30

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

K35.30 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K35.30. Per CMS ICD-10-CM Tabular 2026.

  • Acute appendicitis with localized peritonitis NOS

Inpatient DRG Impact, CC

codes Acute appendicitis with localized peritonitis, without perforation or gangrene. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for K35.30

Local Coverage Determinations (LCDs) from CMS MACs that list K35.30 as a covered diagnosis.

12 LCDs

Showing top 10 of 12 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Retroperitoneal Ultrasound
Article ID: 55336, Effective: 2025-10-01 00:00:00, 797 covered, 0 non-covered
CPT 76775 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K35.30.

2 policies

2 Medicare

Billing and Coding: Retroperitoneal Ultrasound
Policy ID: ART-55336
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421

CPT Codes Commonly Billed with K35.30

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

2 linkages
  • 44970 Laparoscopic appendectomy — acute appendicitis (all types), other appendicitis, unspecified appendicitis, appendicular abscess, fecalith, concretion, diverticulum General Surgery
  • 44950 Open appendectomy — same indications as laparoscopic General Surgery

Codes Adjacent To K35.30

Other codes in section K35-K38 (Diseases of appendix).

ICD-10 K35.30, Billing FAQ

Is ICD-10 code K35.30 billable? +

Yes, K35.30 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to K35.30? +

ICD-10 K35.30 includes: Acute appendicitis with localized peritonitis NOS.

Is K35.30 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with K35.30? +

Procedures frequently paired with K35.30 include: 44970, 44950.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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