K65.4 Sclerosing mesenteritis

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

Applicable to

• Fat necrosis of peritoneum
• (Idiopathic) sclerosing mesenteric fibrosis
• Mesenteric lipodystrophy
• Mesenteric panniculitis
• Retractile mesenteritis

Applies from K65 Peritonitis

Excludes1 (never code together)

• acute appendicitis with generalized peritonitis (K35.2-)
• aseptic peritonitis (T81.6)
• benign paroxysmal peritonitis (E85.0)
• chemical peritonitis (T81.6)
• gonococcal peritonitis (A54.85)
• neonatal peritonitis (P78.0-P78.1)
• pelvic peritonitis, female (N73.3-N73.5)
• periodic familial peritonitis (E85.0)
• peritonitis due to talc or other foreign substance (T81.6)
• peritonitis in chlamydia (A74.81)
• peritonitis in diphtheria (A36.89)
• peritonitis in syphilis (late) (A52.74)
• peritonitis in tuberculosis (A18.31)
• peritonitis with or following abortion or ectopic or molar pregnancy (O00-O07, O08.0)
• peritonitis with or following appendicitis (K35.-)
• puerperal peritonitis (O85)
• retroperitoneal infections (K68.-)

Use additional code

• code (B95-B97), to identify infectious agent, if known

Code also

• if applicable diverticular disease of intestine (K57.-)

Risk adjustment (HCC)

• CMS-HCC V28: HCC 78 — Intestinal Obstruction/Perforation
• CMS-HCC V22: HCC 33 — Intestinal Obstruction/Perforation
• ESRD V24: HCC 33

MS-DRG index

Defines the logic of DRG(s) 393-395 in MDC 06.

Approximate ICD-9-CM (GEMs)

• 567.82 Sclerosing mesenteritis

Code annotations containing back-references to K65.4

Back-references to K65

• Code Also: K57 Diverticular disease of intestine ("if applicable peritonitis K65.-")

Diagnosis Index entries for K65.4

• Fat › necrosis › mesentery
• Fat › necrosis › omentum
• Fibrosis, fibrotic › sclerosing mesenteric (idiopathic)
• Lipodystrophy › mesenteric
• Mesenteritis › retractile
• Mesenteritis › sclerosing
• Necrosis, necrotic (ischemic) › fat, fatty (generalized) › abdominal wall
• Necrosis, necrotic (ischemic) › fat, fatty (generalized) › mesentery
• Necrosis, necrotic (ischemic) › fat, fatty (generalized) › omentum
• Necrosis, necrotic (ischemic) › fat, fatty (generalized) › peritoneum
• Necrosis, necrotic (ischemic) › mesentery › fat
• Necrosis, necrotic (ischemic) › omentum (with mesenteric infarction) › fat
• Necrosis, necrotic (ischemic) › peritoneum (with mesenteric infarction) › fat
• Panniculitis (nodular) (nonsuppurative) › mesenteric

Nearby codes

• K65 Peritonitis
• K65.0 Generalized (acute) peritonitis
• K65.1 Peritoneal abscess
• K65.2 Spontaneous bacterial peritonitis
• K65.3 Choleperitonitis
• K65.4 Sclerosing mesenteritis (this code)
• K65.8 Other peritonitis
• K65.9 Peritonitis, unspecified