ICD-10 K57.1
Non-Billable HeaderDiverticular disease of small intestine without perforation or abscess
About ICD-10-CM K57.1
ICD-10-CM code K57.1 represents Diverticular disease of small intestine without perforation or abscess. This is a non-billable header code in the Digestive System chapter (block K57). The 2026 edition of ICD-10-CM K57.1 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.
Type 1 Excludes
Pure excludes, these codes can never be coded together with K57.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- diverticular disease of both small and large intestine without perforation or abscess (K57.5-)
Medicare LCD Coverage for K57.1
Local Coverage Determinations (LCDs) from CMS MACs that list K57.1 as a covered diagnosis.
This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K57.1.
Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but K57.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.
CPT Codes Commonly Billed with K57.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Codes Adjacent To K57.1
Other codes in section K55-K64 (Other diseases of intestines).
ICD-10 K57.1, Billing FAQ
Is ICD-10 code K57.1 billable? +
No, K57.1 is a non-billable header code. Use a more specific child code from block K57 when submitting claims.
What codes are Type 1 Excludes for K57.1? +
Type 1 Excludes (never code together with K57.1): diverticular disease of both small and large intestine without perforation or abscess (K57.5-)
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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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