# ICD 9 Epiploic Appendagitis



## spstarke

Having trouble finding what feels the best fit for "epiploic appendagitis" in the ICD-9 - what do other folks use?

Thanks!


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## Anna Weaver

The only thing I can find is 751.5


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## WelchCPC

*The "itis"*

The "itis" leads to believe that it is not an anomaly.  I think that 557.0 may be a better fit.


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## sam_son 

Epiploic appendagitis (EA), also known as appendicitis epiploica, hemorrhagic epiploitis, epiplopericolitis, or appendagitis, is a benign and self-limited condition 
Epiploic appendices are small, fat-filled sacs or finger-like projections along the surface of the *lower colon and rectum*. They may become acutely inflamed as a result of torsion 
And there  is no specific code for Epiploic appendagitis (EA), So my suggesion 
is 569.89 Other specified disorder of intestine. but not sure.

Thanks


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## gupta.manishkumar

*Epiploic Appendagitis*

I also had to code EA and I coded it as 569.89. I think this is the best code for this condition. We cannot take 751.5 unless it is mentioned as congenital anomaly.

Thanks


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## vj_tiwari

Hey,

Please go thro' index of diseases....

Appendage --> Intestine(epiploic) --> *751.5* 

Epiploic appendagitis (EA) is an uncommon, benign, self-limiting inflammatory process of the epiploic appendices. Other, older terms for the process include appendicitis epiploica and appendagitis, but these terms are used less now in order to avoid confusion with acute appendicitis.

Epiploic appendagitis does not require surgical or medical intervention. It is self-limiting. Pain can be treated with analgesics and subsides in about a week.

Hope this helps! 

VJ.


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## PURNIMA

But again 751.5 refers to congenital anomalies, unless it is documented as congential, could we take it so? 

In point of ICD coding, I would prefer 569.89, other disorders of Intestine?

Thank You,

Purnima S, CPC


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## ksunstar

I agree with a previous poster, 557.0
Infarction of appendices epiploicae

Epiploic appendagitis (EA), also known as appendicitis epiploica, hemorrhagic epiploitis, epiplopericolitis, or appendagitis, is a benign and self-limited condition of the epiploic appendages that occurs secondary to (torsion or spontaneous venous thrombosis of a draining vein)

Causes of (infarction) - The supplying artery may be blocked by an obstruction (e.g. an arterial embolus, thrombus, or atherosclerotic plaque), may be mechanically compressed (e.g. tumor, volvulus, or hernia), ruptured by trauma (e.g. atherosclerosis or vasculitides), or vasoconstricted (e.g. cocaine vasoconstriction leading to myocardial infarction).

Kristina Smith, CPC


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## spstarke

*thanks!*

Thanks for your input everybody! 

In the future, I will probably look more towards the 569.89 than the 557.0, only as if it's not specified as to the *cause* of the epiploic appendagitis, I don't think I'm comfortable making the jump to the conclusion that it was due to some kind of vascular insufficiency. 

More than helpful! Thanks again, 

spstarke


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## Nandhakumar007

It should be569.89


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## preserene

The appendages are situated along the entire colon, but are typically more abundant and larger in the transverseand sigmoid colon areas. They appear in the fifth month of fetal life and they number 50-100 in an adult human

Epiploic appendagitis is caused by twisting of the appendage and it can become inflammed.
These appendages  are congenital, Like appendix ,it is  vestigeal  and mostly like other appendages are protective and plays  a defence  role and are without symptoms, until it show signs of inflammation and that too when acute, which are medically treated .

It cannot be coded into the Infarction or disorders of vascular origin until it is proved so.
 So the most commonest form is appendagitis and the code *715.5 *is the nearest level of description.

Secondly, *the fact that it is congenital does not exclude it *because some of the congenital anomalies do not manifest until later age or may not manifest with any symptom at all through lifetime. But thye are still and just there.
(eg) appendix for many/some do not show up at all till life time. Some of the embryonal cyst like paraoopheron, gartners cysts go unnoticedat all/ or till they manifest withsome symptoms and signs .  The list goes on and on.


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## sam_son 

Epiploic appendices are small, fat-filled sacs or finger-like projections along the surface of the lower colon and rectum. They may become acutely inflamed as a result of torsion - this is Epiploic Appendagitis.

I agree appendages are congenital, but this inflamation (Epiploic Appendagitis) are not congenital .

Appendix is present for all humans till their life time , but appendicitis is diffrent . i.e. inflamation or infection is aquired . Like Sinus is normally present for all humans , but Sinusitis  affects some people.

Also I agree with many conditions were present from birth till their life time . 

But in this case the inflamation was not present from birth. 
This does'nt mean i am not agree with you, but your answer needs more explanation.

I think you answer is 751.5 not 715.5. please explain more clearly.


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## preserene

Yes Samson,  the code number is 751.5. it was a typing error; I am  Sorry.

my explanation is almost in par with you. but i believe that we cannot expect the '-itis' from birth. It is an anomaly.The patient presents for the occurance of the condition later.

Epiploic appendagitis (EA) is an inflammation of these structures. They are an average of 3 cm in length but have been reported to be up to 15 cm long. pedunculated projections of adipose tissue that project from the antimesenteric side of the colon. The appendages can undergo torsion on their stalks, becoming ischemic and necrotic. This is the usual etiology for symptoms related to EA. Additional pathologic processes include vascular thrombosis, lymphoid hyperplasia, or spread of inflammation and infection from an adjacent diverticulitis. 
It is a disease process. So the structure is congenital present at birth and the disease can ocur any time later .The presenting patients are usually in their 2-4th decade (average 35yrs) of life. The physiologic function of the epiploic appendixes is not understood.

what i feel is unless it is documented with one of the above said conditions like vascular thrombosis, lymphoid hyperpalsia, or spread of infection-like peritonitis, adhesion associatedwith diverticulitis/obstruction,ischemia necrosis and so on (which are rare),it can be safely code with 751.5. in addtion to other diagnoses.


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## nampip@yahoo.in

*Epiploic appendagitis*

Please provide me correct icd code for the  Epiploic appendagitis (EA) , 

Thanks

Nampip CPC


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## srinivas r sajja

I'd go with 557.0.


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## drew56

*Epiploic Appendagitis*

This is also known as EPIPLOITIS (according to Up To Date). Epiploitis codes to peritonitis in ICD-9 and gives a code of *567.89* (other specified peritonitis). This code would cover the inflammation present and is probably the closest one to the actual diagnosis.


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## clgray

*epiploic appendage*

according to the General surgeons i work with the proper code for this would be   558.9


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## kalimuthu

It Should be 569.89


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## ANITAV

*epiploic appendagitis*

Epiploic appendagitis  

      Coding Clinic, Second Quarter 2013 Page: 3 Effective with discharges: July 8, 2013

      Related Information
Question:



The patient was admitted to the hospital with left lower quadrant pain, nausea and vomiting and diarrhea. CT scan of the abdomen showed epiploic appendagitis. The provider listed "Epiploic appendagitis" in the final diagnostic statement. How should "epiploic appendagitis" be coded? Can we code this as generalized peritonitis?



Answer:


Query the provider as to whether this is a localized peritonitis (inflammation in the peritoneum). If the provider confirms and documents the diagnosis as peritonitis, it may be coded as such. Assign code 567.9, Unspecified peritonitis. Assign also code 751.5, Other anomalies of intestine, for the epiploic appendage. Although the Alphabetic Index crossreferences "peritonitis," under the term "epiploitis," if the patient does not have peritonitis, code 567.9 should not be assigned; rather assign code 569.89, Other specified disorders of the intestine, other.


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## sivdon

*outline for ED coding*

Dear Anita,

Could you please give me the general idea for ED coding.How to code, what are the codes used, any sub topics related to this. i am CPC-A.I would like to learn ED coding.For that i need your idea for preparing such topics.

Awaiting for your reply.

Thank you,
Sivdon.


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## Raghupathy.Dharmaraj

*Epiploic appendagitis*

I would use 569.89

Thanks,
Raghupathy Dharmaraj, CPC,CPC-H,CEDC


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## DeLisa_Smith

*See Coding Clinic 2nd Q 2013, page 31*

"Question:

The patient was admitted to the hospital with left lower quadrant pain, nausea and vomiting and diarrhea. CT scan of the abdomen showed epiploic appendagitis. The provider listed "Epiploic appendagitis" in the final diagnostic statement. How should "epiploic appendagitis" be coded in ICD-10-CM?

Answer:

Query the provider as to whether this is a localized peritonitis (inflammation in the peritoneum). If the provider confirms and documents the diagnosis as peritonitis, it may be coded as such. Assign code K65.9, Peritonitis, unspecified. Assign also code Q43.8, Other specified congenital anomalies of the intestine, for the epiploic appendage. Although the Alphabetic Index cross-references "peritonitis," under the term "epiploitis," if the patient does not have peritonitis, code K65.9 should not be assigned. Assign instead code K63.89, Other specified diseases of the intestine."


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## zspoppa

*epiloic appendagitis ICD-10*

K63.89 Other specified diseases of intestine


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