ICD-10 K57.13
Billable / Specific MCCDiverticulitis of small intestine without perforation or abscess with bleeding
About ICD-10-CM K57.13
ICD-10-CM code K57.13 represents Diverticulitis of small intestine without perforation or abscess with bleeding. This is a billable/specific code in the Digestive System chapter (block K57). The 2026 edition of ICD-10-CM K57.13 became effective on October 1, 2025.
Coding Tips for K57.13
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K57.13 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Inpatient DRG Impact, MCC
codes Diverticulitis of small intestine without perforation or abscess with bleeding. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for K57.13
Local Coverage Determinations (LCDs) from CMS MACs that list K57.13 as a covered diagnosis.
Showing top 10 of 37 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K57.13.
5 Medicare
Convert K57.13 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| K57.13 | 56203 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K57.13
Other codes in section K55-K64 (Other diseases of intestines).
ICD-10 K57.13, Billing FAQ
Is ICD-10 code K57.13 billable? +
Yes, K57.13 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is K57.13 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with K57.13? +
Procedures frequently paired with K57.13 include: 91111, 91110.
What ICD-9 codes does K57.13 map to? +
Per CMS GEMs, K57.13 maps to ICD-9 codes: 56203. Useful for legacy data review and historical claim analysis.
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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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