K63.1
BillablePerforation of intestine (nontraumatic)
HCC Category Mapping
V28HCC 78 — Intestinal Obstruction/Perforation
0.000V24HCC 33 — Intestinal Obstruction/Perforation
0.226ESRDHCC 33 — Intestinal Obstruction/Perforation
0.000What This Code Means
A hole or rupture in the intestinal wall that is not caused by trauma, allowing intestinal contents to leak into the abdomen.
Coding Tips
- •Document the cause if known (ulcer, diverticulitis, inflammatory bowel disease)
- •This is a serious condition; ensure sepsis codes are added if applicable
Clinical Significance
K63.1 represents nontraumatic perforation of the intestine, a surgical emergency where a hole develops in the bowel wall allowing intestinal contents to leak into the peritoneal cavity. This condition can rapidly lead to peritonitis, sepsis, and death if not immediately recognized and surgically repaired.
Documentation Requirements
- ✓Imaging studies demonstrating free air or intestinal perforation
- ✓Clinical signs of peritonitis and acute abdomen
- ✓Documentation that perforation is not due to trauma
- ✓Emergency surgical consultation and intervention
- ✓Operative findings confirming intestinal perforation
- ✓Assessment of underlying cause (ischemia, inflammation, obstruction)
- ✓Post-operative management including antibiotics and monitoring
- ✓Documentation of repair method (primary repair vs resection)
Excludes 1 — Do NOT code together
Excludes 2 — Not included here, may code separately
Commonly Confused Codes
S36.438A — Laceration of small intestine initial encounter (traumatic rather than nontraumatic)K65.0 — Generalized peritonitis (complication rather than primary perforation)K92.2 — Gastrointestinal hemorrhage (bleeding rather than perforation)K55.0 — Acute vascular disorders (ischemia that may cause perforation)T81.31XA — Disruption of external operation wound (post-surgical rather than spontaneous)
Code Hierarchy
└K63Other diseases of intestine└K63.1Perforation of intestine (nontraumatic)
└K63.1Perforation of intestine (nontraumatic)