K65.4

Billable

Sclerosing mesenteritis

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 chronic inflammatory condition of the peritoneum and mesentery characterized by fibrosis and thickening, which can cause bowel obstruction.

Coding Tips

•Determine if this is idiopathic or secondary to prior surgery, radiation, or beta-blocker use
•Code any resulting bowel obstruction separately if present

Clinical Significance

K65.4 represents sclerosing mesenteritis, a rare chronic inflammatory condition affecting the mesentery with progressive fibrosis and thickening. This condition can cause bowel obstruction, malabsorption, and significant morbidity, often requiring immunosuppressive therapy and surgical intervention for complications.

Documentation Requirements

✓Imaging studies showing characteristic mesenteric thickening and fibrosis
✓Histopathologic confirmation when tissue obtained
✓Documentation of chronic inflammatory process in mesentery
✓Assessment for bowel obstruction or other complications
✓Immunosuppressive therapy consideration and monitoring
✓Nutritional assessment and support when indicated
✓Surgical intervention for obstructive complications
✓Long-term monitoring for disease progression

Commonly Confused Codes

K56.69 — Other intestinal obstruction (when obstruction is primary rather than sclerosing mesenteritis)C78.6 — Secondary malignant neoplasm of peritoneum (malignant rather than inflammatory)K66.1 — Hemoperitoneum (bleeding rather than inflammatory process)K65.8 — Other peritonitis (acute rather than chronic sclerosing process)D48.1 — Neoplasm of uncertain behavior of peritoneum (neoplastic rather than inflammatory)

Code Hierarchy

└K65Peritonitis └K65.4Sclerosing mesenteritis

└K65.4Sclerosing mesenteritis