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APPENDICITIS

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ICD-9-CM CODES

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  • 540 Acute appendicitis

  • 540.0 Acute appendicitis with generalized peritonitis

  • 540.1 Acute appendicitis with peritoneal abscess

  • 540.9 Acute appendicitis without mention of peritonitis

  • 541 Appendicitis, unqualified

  • 542 Other appendicitis

  • 543.0 Hyperplasia of appendix (lymphoid)

  • 543.9 Other and unspecified diseases of appendix

  • Associated physical therapy diagnoses

    • 315.4 Developmental coordination disorder (clumsiness, dyspraxia and/or specific motor development disorder)

    • 718.45 Contracture of joint, pelvic region and thigh

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.70 Other malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

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ICD-10-CM CODES

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  • K35.2 Acute appendicitis with generalized peritonitis

  • K35.3 Acute appendicitis with localized peritonitis

  • K35.80 Unspecified acute appendicitis

  • K35.89 Other acute appendicitis

  • K36 Other appendicitis

  • K37 Unspecified appendicitis

  • 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

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PREFERRED PRACTICE PATTERN

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  • As of June, 2014, the APTA Guide to Physical Therapist Practice does not include practice patterns for organ system pathology; therefore, the associated or secondary musculoskeletal, cardiovascular/pulmonary, or potential neuromuscular patterns would be indicated.

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FIGURE 30-1

Pathogenesis and complications of acute appendicitis. (From Chandrasoma P, Taylor CR. Concise Pathology. 3rd ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

Graphic Jump Location
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PATIENT PRESENTATION

A 23-year-old male college student presents with severe abdominal pain for 3 hours that woke him up from sleep. Pain is sharp, 9/10 and in the right lower quadrant. Laying still helps the pain and movement makes it worse. He took two 250 mg ibuprofen, but the pain has been constant and getting worse. Vitals are Pulse: 120, Respirations: 24, Blood Pressure: 134/78, Temperature: 100°F, and SpO2% of 99%. On exam the patient is alert and oriented, but visibly uncomfortable. Abdominal exam reveals guarding in the right lower quadrant with rebound tenderness. A STAT CBC shows a mildly elevated WBC count and a CT scan shows inflammation of the appendix.

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KEY FEATURES
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Description
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  • Inflammation of the appendix

  • Pain in the lower abdominal region on the right side

  • Appendix can rupture when blocked by an object, tumor, or feces

  • Appendix is a tube of tissue off of the large intestine with an unknown function

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Essentials of Diagnosis
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  • Right abdominal and side (flank) pain

  • Positive cultures

  • McBurney point, tip of right 12th rib tenderness

  • Palpation over appendix

  • Lab tests

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General Considerations
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  • If untreated can possibly rupture

  • Possible referred pain to back, pelvic region, or ...

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