Part B Insider (Multispecialty) Coding Alert

Question: Our physician performed a procedure to remove the patient’s appendix. The pathology reported noted, "diverticulum of appendix." I know we would use diagnosis 540 for appendicitis, but am not sure about this condition. What do we report?

Answer: You should choose 543.9 (Other and unspecified diseases of appendix) for diverticulum of appendix. Even if the patient presented with appendicitis symptoms, you should code the diverticulum diagnosis if it’s known at the time of billing.

Future coding: Beginning Oct. 1, 2014, you’ll have a specific code for the condition in ICD-10 -- K38.2 (Diverticulum of appendix). This is part of a larger group of more-specific codes that will replace 543.9 under the new code set. Those expanded choices will be:

• K38.1 -- Appendicular concretions
• K38.2 -- Diverticulum of appendix
• K38.3 -- Fistula of appendix
• K38.8 -- Other specified diseases of appendix
• K38.9 -- Disease of appendix, unspecified.