ICD-10-CM Code For Other Diseases Of Appendix: Group Overview

The International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code group K38 includes non-appendicitis appendix conditions such as appendix obstruction, other specified appendix disorders, and unspecified appendix diseases that affect appendix structure or function. These ICD-10-CM diagnosis codes are used to document clinical scenarios involving appendix-related pathology that is not acute appendicitis, capturing disease severity, organ involvement, or clinical complexity relevant to this group. Accurate coding within the ICD-10-CM K38 group supports proper claim adjudication and complete clinical documentation for appropriate reimbursement.

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ICD-10-CM K38: Other Diseases Of Appendix Overview

The ICD-10-CM K38 group covers non-appendicitis diseases of the appendix, including appendix obstruction, other specified appendix disorders, and unspecified appendix conditions. These diagnoses affect the gastrointestinal system and may require different levels of clinical management and documentation. Accurate coding matters for correct claim processing and reflecting clinical complexity for reimbursement.

When to Use

Use a code from this group when the clinical record identifies an appendix condition that is not acute appendicitis, such as appendiceal obstruction or other specified appendix disorders. Select the most specific code available that reflects the documented appendix diagnosis and any associated clinical details.

ICD-10-CM Codes

6 rows

ICD-10-CM Code	Description
K38.0	Hyperplasia of appendix
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

DRG Codes

3 rows

DRG Code	Description
393	Other Digestive System Diagnoses with MCC
394	Other Digestive System Diagnoses with CC
395	Other Digestive System Diagnoses without CC/MCC

Typical Clinical Scenarios

An adult presents to the emergency department with acute right lower quadrant abdominal pain, fever, and focal peritoneal signs after 24 hours of worsening symptoms. Imaging shows a localized appendiceal inflammation without perforation, and the clinician documents an acute appendiceal condition related to the appendix itself; a code describing acute appendiceal disease is assigned. Typical codes: K38.2, K38.3.
A middle-aged patient is seen in outpatient surgery clinic for a history of recurrent right lower quadrant discomfort and intermittent vague abdominal pain over months; prior evaluations excluded acute appendicitis but note chronic appendiceal inflammation on previous pathology. Because the visit addresses a chronic or residual appendix disorder rather than an acute process, a chronic appendix-related code is used. Typical codes: K38.1, K38.8.
A hospitalized elderly patient with sepsis is found to have a ruptured appendix with generalized peritonitis as a complicating factor in their hospital course; the appendix-related condition is documented as a complication contributing to the acute illness and care decisions. A code reflecting a complicated appendiceal condition or unspecified appendix disease is assigned to capture this comorbidity. Typical codes: K38.0, K38.9.

Related Codes

K35-ACUTE-APPENDICITIS

ICD-10-CM Code For Acute Appendicitis: Group Overview

K36-OTHER-APPENDICITIS

ICD-10-CM Code For Other Appendicitis: Group Overview

K37-UNSPECIFIED-APPENDICITIS

ICD-10-CM Code For Unspecified Appendicitis: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-CM Codes

6 rows

ICD-10-CM Code	Description
K38.0	Hyperplasia of appendix
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

DRG Codes

3 rows

DRG Code	Description
393	Other Digestive System Diagnoses with MCC
394	Other Digestive System Diagnoses with CC
395	Other Digestive System Diagnoses without CC/MCC

Typical Clinical Scenarios

An adult presents to the emergency department with acute right lower quadrant abdominal pain, fever, and focal peritoneal signs after 24 hours of worsening symptoms. Imaging shows a localized appendiceal inflammation without perforation, and the clinician documents an acute appendiceal condition related to the appendix itself; a code describing acute appendiceal disease is assigned. Typical codes: K38.2, K38.3.
A middle-aged patient is seen in outpatient surgery clinic for a history of recurrent right lower quadrant discomfort and intermittent vague abdominal pain over months; prior evaluations excluded acute appendicitis but note chronic appendiceal inflammation on previous pathology. Because the visit addresses a chronic or residual appendix disorder rather than an acute process, a chronic appendix-related code is used. Typical codes: K38.1, K38.8.
A hospitalized elderly patient with sepsis is found to have a ruptured appendix with generalized peritonitis as a complicating factor in their hospital course; the appendix-related condition is documented as a complication contributing to the acute illness and care decisions. A code reflecting a complicated appendiceal condition or unspecified appendix disease is assigned to capture this comorbidity. Typical codes: K38.0, K38.9.

Related Codes

K35-ACUTE-APPENDICITIS

ICD-10-CM Code For Acute Appendicitis: Group Overview

K36-OTHER-APPENDICITIS

ICD-10-CM Code For Other Appendicitis: Group Overview

K37-UNSPECIFIED-APPENDICITIS

ICD-10-CM Code For Unspecified Appendicitis: Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-CM Code For Other Diseases Of Appendix: Group Overview

Sign up for ICD-10-CM Code For Other Diseases Of Appendix: Group Overview policy alerts

ICD-10-CM K38: Other Diseases Of Appendix Overview

ICD-10-CM Code For Other Diseases Of Appendix: Group Overview

Sign up for ICD-10-CM Code For Other Diseases Of Appendix: Group Overview policy alerts

ICD-10-CM K38: Other Diseases Of Appendix Overview

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

What conditions are included in ICD-10-CM group K38?

How does accurate coding within `K38` affect reimbursement?

Which DRGs are related to the `K38` diagnosis group?

What types of appendix pathology does the `K38` group capture?

When should someone use `K38.9` versus a more specific `K38` code?

References

When to Use

ICD-10-CM Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

What conditions are included in ICD-10-CM group K38?

How does accurate coding within `K38` affect reimbursement?

Which DRGs are related to the `K38` diagnosis group?

What types of appendix pathology does the `K38` group capture?

When should someone use `K38.9` versus a more specific `K38` code?

References