Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 188

SOP bulletin 214

ICD Coding

• ICD-9-CM Codes: 562.1
• ICD-10-AM Codes: K57.2, K57.3

Brief description

A diverticulum is an abnormal sac or pouch formed at a weak point in the wall of an organ such as the colon or bladder. This SOP covers diverticulae of the colon in the form of diverticulosis (without inflammation - whether symptomatic or not) and diverticulitis (with inflammation).  Complications of colonic diverticular disease (diverticular bleeding, perforation of a diverticulum, diverticular abscess and diverticulitis complicated by fistula) are also covered by the SOP.

Confirming the diagnosis

Asymptomatic disease requires colonoscopy, CT scan, or other imaging or visualisation to confirm the diagnosis.   With symptomatic disease the symptoms are generally non-specific and again colonoscopy, CT scan, or other imaging or visualisation is required for confirmation and exclusion of other pathologies.

The relevant medical specialist is a gastroeterologist or general/colorectal surgeon.

Additional diagnoses covered by SOP

• Diverticulitis of the colon
• Diverticulosis of the colon
• Diverticulae of the colon

Conditions not covered by SOP

• Diverticular disease of the small intestine^#
• Diverticular disease of the bladder^#

^# non-SOP condition

Clinical onset

In most cases clinical onset will be at the time of diagnosis.  Symptoms are generally non-specific and will typically not allow back-dating of onset to an earlier time.

Clinical worsening

The normal course of diverticulosis varies.  It may remain asymptomatic or progress to episodes of bleeding or diverticulitis in around 25 percent of patients.  Most people with uncomplicated diverticulitis respond to medical treatment, while approximately 15 percent of patients will need surgery.  Clinical worsening could be evidenced by progression from diverticulosis to diverticulitis, or by the development of complications of diverticulitis (bleeding, abscess, perforation, fistula).  Establishing whether there has been worsening beyond the normal course of the disease may require specialist opinion.