K65.2

Billable

Spontaneous bacterial peritonitis

HCC Category Mapping

V28HCC 78 — Intestinal Obstruction/Perforation

0.000

V24HCC 33 — Intestinal Obstruction/Perforation

0.226

ESRDHCC 33 — Intestinal Obstruction/Perforation

0.000

What This Code Means

A serious bacterial infection of the peritoneum that develops spontaneously without an obvious source like perforation, often occurring in patients with liver disease or ascites.

Coding Tips

•Document the causative organism if identified through culture
•Note any associated liver disease or cirrhosis as these are common risk factors

Clinical Significance

K65.2 represents spontaneous bacterial peritonitis (SBP), a serious bacterial infection of ascitic fluid that occurs without an obvious source of contamination. This condition primarily affects patients with liver disease and ascites, requiring immediate antibiotic therapy and representing a poor prognostic indicator in cirrhotic patients.

Documentation Requirements

✓Documentation of ascites with bacterial infection
✓Paracentesis results showing elevated neutrophil count (>250 cells/μL)
✓Evidence of spontaneous onset without obvious source
✓Underlying liver disease or cirrhosis documentation
✓Antibiotic therapy initiated based on SBP protocols
✓Culture results from ascitic fluid when available
✓Prophylactic antibiotics consideration for recurrence prevention
✓Assessment of liver disease severity and prognosis

Excludes 1 — Do NOT code together

bacterial peritonitis NOS (K65.9)

Commonly Confused Codes

K65.0 — Generalized peritonitis (generalized inflammation rather than SBP)K65.1 — Peritoneal abscess (localized abscess rather than diffuse SBP)R18.8 — Other ascites (ascites without bacterial infection)K76.6 — Portal hypertension (underlying condition rather than SBP)A41.9 — Sepsis unspecified organism (systemic sepsis rather than localized SBP)

Code Hierarchy

└K65Peritonitis └K65.2Spontaneous bacterial peritonitis

└K65.2Spontaneous bacterial peritonitis