K35.32 Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess

Billable ICD-10-CM code, FY2026. Acts as a Major Complication or Comorbidity (MCC) as a secondary diagnosis.

Applicable to

• (Acute) appendicitis with perforation NOS
• Perforated appendix NOS
• Ruptured appendix (with localized peritonitis) NOS

MS-DRG index

Defines the logic of DRG(s) 371-373 in MDC 06.

Code annotations containing back-references to K35.32

Back-references to K35.3

• Type 1 Excludes: K37 Unspecified appendicitis ("unspecified appendicitis with peritonitis (K35.2-, K35.3-)")
• Type 2 Excludes: K63.0 Abscess of intestine ("abscess of appendix (K35.3-)")
• Type 2 Excludes: K63.1 Perforation of intestine (nontraumatic) ("perforation (nontraumatic) of appendix (K35.2-, K35.3-)")

Back-references to K35

• Type 1 Excludes: K65 Peritonitis ("peritonitis with or following appendicitis (K35.-)")

Diagnosis Index entries for K35.32

• Appendicitis (pneumococcal) (retrocecal) › with › perforation NOS
• Appendicitis (pneumococcal) (retrocecal) › with › peritonitis NEC › localized › with › perforation
• Appendicitis (pneumococcal) (retrocecal) › with › peritonitis NEC › rupture (with localized peritonitis)
• Appendicitis (pneumococcal) (retrocecal) › acute (catarrhal) (fulminating) (obstructive) (retrocecal) (suppurative) › with › peritonitis NEC › localized › with › perforation
• Appendicitis (pneumococcal) (retrocecal) › ruptured NOS (with localized peritonitis)
• Perforation, perforated (nontraumatic) (of) › appendix
• Perforation, perforated (nontraumatic) (of) › appendix › with localized peritonitis
• Perforation, perforated (nontraumatic) (of) › cecum
• Perforation, perforated (nontraumatic) (of) › cecum › with localized peritonitis
• Peritonitis (adhesive) (bacterial) (fibrinous) (hemorrhagic) (idiopathic) (localized) (perforative) (primary) (with adhesions) (with effusion) › with or following › appendicitis › with perforation or rupture
• Rupture, ruptured › appendix (with peritonitis)
• Rupture, ruptured › appendix (with peritonitis) › with localized peritonitis

Nearby codes

• K35.211 Acute appendicitis with generalized peritonitis, with perforation and abscess
• K35.219 Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation
• K35.3 Acute appendicitis with localized peritonitis
• K35.30 Acute appendicitis with localized peritonitis, without perforation or gangrene
• K35.31 Acute appendicitis with localized peritonitis and gangrene, without perforation
• K35.32 Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess (this code)
• K35.33 Acute appendicitis with perforation, localized peritonitis, and gangrene, with abscess
• K35.8 Other and unspecified acute appendicitis
• K35.80 Unspecified acute appendicitis
• K35.89 Other acute appendicitis
• K35.890 Other acute appendicitis without perforation or gangrene