https://links.lww.com/TA/C812

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Supplemental Table 1: International Classification of Diseases 10^th Edition Codes Utilized to Qualify Complex Emergency General Surgery Diseases

Appendicitis

Not Complex Complex

K35

Acute appendicitis

K352 Acute appendicitis with generalized peritonitis K358

Other and unspecified acute appendicitis

K3520 Acute appendicitis with

generalized peritonitis, without abscess

K3580

Acute appendicitis unspecified

K3521 Acute appendicitis with generalized peritonitis, with abscess

K3589

Other acute appendicitis

K353 Acute appendicitis with localized peritonitis

K3589

0 Other acute appendicitis without perforation or gangrene

K3530 Acute appendicitis with localized peritonitis, without perforation

K3589

1 Other acute appendicitis without perforation, with gangrene

K3531 Acute appendicitis with localized peritonitis and gangrene, without perforation

K37

Unspecified appendicitis

K3532 Acute appendicitis with perforation and localized peritonitis, without abscess K3533 Acute appendicitis with

perforation and localized peritonitis, with abscess

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Cholecystitis

K8000

Calculus of gallbladder with acute cholecystitis without obstruction

K822 Perforation of gallbladder

K8001

Calculus of gallbladder with acute cholecystitis with obstruction

K823 Fistula of gallbladder

K8012

Calculus of gallbladder with acute and chronic cholecystitis without obstructio

K8013

Calculus of gallbladder with acute and chronic cholecystitis with obstruction

K8042

Calculus of bile duct with acute cholecystitis without obstruction K8043

Calculus of bile duct with acute cholecystitis with obstruction K8046

Calculus of bile duct with acute and chronic cholecystitis without

obstruction K8047

Calculus of bile duct with acute and chronic cholecystitis with

obstruction K8062

Calculus gallbladder and bile duct with acute cholecystitis without obstruction

K0863

Calculus of gallbladder and bile duct

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with acute cholecystitis with obstruction

K8066

Calculus of gallbladder and bile duct with acute and chronic cholecystitis without obstruction

K8067

Calculus of gallbladder and bile duct with acute and chronic cholecystitis with obstruction

K810

Acute cholecystitis (without calculus)

K812

Acute cholecystitis with chronic cholecystitis (without calculus) K820

Obstruction of gallbladder K821

Hydrops of gallbladder

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Diverticulitis

K5732 Diverticulitis of large intestine without perforation or abscess without bleeding

K5720 Diverticulitis of large intestine with perforation and abscess without bleeding

K5733 Diverticulitis of large intestine without perforation or abscess with bleeding

K5721 Diverticulitis of large intestine with perforation and abscess with bleeding

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Breast Infection

Not Complex Complex:

Diagnosis of breast cellulitis or breast abscess (any in left column)

AND necrotizing soft tissue infection (one of the following three codes):

N610

Mastitis without abscess

A480 Gas gangrene

O91011

Infection of nipple associated with pregnancy, first trimester

I96 Gangrene, not elsewhere classified

O91012

Infection of nipple associated with pregnancy, second trimester

M726

Necrotizing fasciitis

O91013

Infection of nipple associated with pregnancy, third trimester

O91019

Infection of nipple associated with pregnancy, unspecified trimester O9102

Infection of nipple associated with the puerperium

O9103

Infection of nipple associated with lactation

O91211

Nonpurulent mastitis associated with pregnancy, first trimester O91212

Nonpurulent mastitis associated with pregnancy, second trimester O91213

Nonpurulent mastitis associated

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with pregnancy, third trimester O91219

Nonpurulent mastitis associated with pregnancy, unspecified trimester

O9122

Nonpurulent mastitis associated with the puerperium

O9123

Nonpurulent mastitis associated with lactation

N611

Abscess of the breast and nipple O91111

Abscess of breast associated with pregnancy, first trimester

O91112

Abscess of breast associated with pregnancy, second trimester

O91113 Abscess of breast associated with pregnancy, third trimester

O91119 Abscess of breast associated with pregnancy, unspecified trimester

O9112 Abscess of breast associated with the puerperium

O9113 Abscess of breast associated with lactation

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Esophageal Perforation

K2210

Ulcer of esophagus without bleeding

K223 Perforation of esophagus

K2211

Ulcer of esophagus with bleeding

S27813 A

Laceration of esophagus (thoracic part)

K226

Gastroesophageal laceration hemorrhage syndrome

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Perforated Ulcer

Not Complex: Complex

Perforated ulcer (left column) AND

Abscess or peritonitis (right column) K251

Acute gastric ulcer with perforation K659 Peritonitis, unspecified K252

Acute gastric ulcer with both hemorrhage and perforation

K651 Peritoneal abscess

K255

Chronic or unspecified gastric ulcer with perforation

K6811 Postprocedural retroperitoneal abscess

K256

Chronic or unspecified gastric ulcer with both hemorrhage and perforation

K6812 Psoas muscle abscess

K261

Acute duodenal ulcer with perforation K6819 Other retroperitoneal abscess K262

Acute duodenal ulcer with both hemorrhage and perforation

K650 Generalized (acute) peritonitis

K265

Chronic or unspecified duodenal ulcer with perforation

N733 Female acute pelvic peritonitis

K266

Chronic or unspecified duodenal ulcer with both hemorrhage and perforation

N735 Female pelvic peritonitis, unspecified

K271

Acute peptic ulcer, site unspecified, with perforation

K272

Acute peptic ulcer, site unspecified,

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with both hemorrhage and perforation K275

Chronic or unspecified peptic ulcer, site unspecified, with perforation K276

Chronic or unspecified peptic ulcer, site unspecified, with both

hemorrhage and perforation

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Pleural Space Infection Not Complex:

Empyema without fistula, fibrothorax, NSTI, or extra-pleural infection

Complex

1. Empyema with fisula (860) 2. Empyema (J869) + Fibrothorax

(J941)

3. Empyema (J869) + NSTI (A480 or M726)

4. Empyema + Extra-pleural infection (J9851, K650, K651, K659)

J869

Pyothorax without fistula J860 Pyothorax with fistula

J941 Fibrothorax A480

Gas gangrene M726

Necrotizing fasciitis

J9851 Mediastinitis

K650 Generalized peritonitis

K659 Peritonitis, unspecified

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Intestinal Obstruction (Without Hernia)

Not Complex:

Intestinal Obstruction (without Hernia);

***see hernia page for exclusion codes***

Complex:

Intestinal obstruction without hernia (any of the codes from the left column, again

excluding hernia codes) AND

Any of the following codes indicating gangrene, peritonitis, perforation, or

abscess K561

Intussusception K55021

Focal (segmental) acute infarction of small intestine

K562

Volvulus K55022

Diffuse acute infarction of small intestine

K563

Gallstone ileus K55029

Acute infarction of small intestine, extent unspecified K5641

Fecal Impaction K55041

Focal (segmental) acute infarction of large intestine K5649

Other impaction of intestine K55042

Diffuse acute infarction of large intestine

K565

Intestinal adhesions [bands] with obstruction (postprocedural) (postinfection)

K55049 Acute infarction of large intestine, extent unspecified

K5660

Unspecified intestinal obstruction K55061

Focal acute infarction of intestine, part unspecified

K5669

Other intestinal obstruction K55062

Diffuse acute infarction of intestine, part unspecified

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K913

Postprocedural intestinal obstruction K55069

Acute infarction of intestine, part and extent unspecified

K631 Perforation of intestine (non- traumatic)

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Infectious Colitis (C. Diff)

C. Diff (A047) AND

Any of the following codes indicating colonic necrosis or perforation:

A047

Enterocolitis due to Clostridium

difficile K55031

Focal (segmental) acute ischemia of large intestine

K55032

Diffuse acute (reversible) ischemia of large intestine

K55039

Acute ischemia of large intestine, extent unspecified

K55041 Focal (segmental) acute infarction of large intestine

K55049

Acute infarction of large intestine, extent unspecified

K55051

Focal acute ischemia of intestine, part unspecified

K55052

Diffuse acute ischemia of intestine, part unspecified K55059 Acute ischemia of intestine, part

and extent unspecified

K55061 Focal acute infarction of intestine, part unspecified

K55069 Acute infarction of intestine, part and extent unspecified

K559 Vascular disorder of intestine, unspecified

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K650

Generalized (acute) peritonitis

K651

Peritoneal abscess

N735

Female pelvic peritonitis, unspecified

K55042

K55062

Diffuse acute infarction of intestine, part unspecified

Intestinal Arterial Ischemia

1. focal acute intestinal infarction (K55021, K55029, K55041, K55049, K55061, K55069) AND perforation or peritonitis (K631, K651, K650, K659, N733, N735)

OR

2. pan-intestinal infarction (K55022, K55042, K55062)

K55011

Focal (segmental) acute ischemia of small intestine

K55012 Diffuse acute (reversible) K651 Peritoneal abscess

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ischemia of small intestine

K55019 Acute ischemia of small intestine, extent unspecified

K650

Generalized (acute) peritonitis

K55031 Focal (segmental) acute ischemia of large intestine

K659

Peritonitis, unspecified

K55032 Diffuse acute (reversible) ischemia of large intestine

K55039 Acute ischemia of large intestine, extent unspecified

K55051 Focal acute ischemia of intestine, part unspecified

K55022

Diffuse acute infarction of small intestine

K55052 Diffuse acute ischemia of intestine, part unspecified

K55042

K55059

Acute ischemia of intestine, part and extent unspecified

K55062

Diffuse acute infarction of intestine, part unspecified K559

Vascular disorder of intestine, unspecified

K55021

Focal (segmental) acute infarction of small intestine K55029

Acute infarction of small intestine, extent unspecified

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K55041

Focal (segmental) acute infarction of large intestine

Pancreatitis

Not Complex:

Pancreatitis with no evidence of infection and no extra-peritoneal necrosis

Complex:

1) Infected necrosis

2) Any pancreatiis from the left column AND

Retroperitoneal infection

3) Any pancreatiis from the left column AND

Extra-pancreatic necrosis K8500

Idiopathic acute pancreatitis

without necrosis or infection Infected Necrosis:

K8510

Biliary acute pancreatitis without necrosis or infection

K8502

Idiopathic acute pancreatitis with infected necrosis

K8520

Alcohol induced acute pancreatitis without necrosis or infection

K8512

Biliary acute pancreatitis with infected necrosis

K8530

Drug induced acute pancreatitis without necrosis or infection

K8522 Alcohol induced acute pancreatitis with infected necrosis

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K8580

Other acute pancreatitis without

necrosis or infection K8532 Drug induced acute pancreatitis with infected necrosis

K8590

Acute pancreatitis without necrosis

or infection, unspecified K8582 Other acute pancreatitis with infected necrosis

K8501

Idiopathic acute pancreatitis with uninfected necrosis

K8592 Acute pancreatitis with infected necrosis, unspecified

K8511

Biliary acute pancreatitis with uninfected necrosis

Retroperitoneal infection:

K8521

Alcohol induced acute pancreatitis with uninfected necrosis

K6811 Retroperitoneal abscess

K8531

Drug induced acute pancreatitis with uninfected necrosis

K6812 Psoas muscle abscess

K8581

Other acute pancreatitis with uninfected necrosis

K6819 Other retroperitoneal abscess

K8591

Acute pancreatitis with uninfected

necrosis, unspecified Extra-pancreatic necrosis:

K529 Noninfective gastroenteritis and colitis, unspecified

K55011 Focal (segmental) acute ischemia of small intestine

K55012 Diffuse acute (reversible) ischemia of small intestine

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K55019 Acute ischemia of small intestine, extent unspecified

K55021 Focal (segmental) acute infarction of small intestine

K55022 Diffuse acute infarction of small intestine

K55029 Acute infarction of small intestine, extent unspecified

K55031 Focal (segmental) acute ischemia of large intestine

K55032 Diffuse acute (reversible) ischemia of large intestine

K55039 Acute ischemia of large intestine, extent unspecified

K55041 Focal (segmental) acute infarction of large intestine

K55042 Diffuse acute infarction of large intestine

K55051 Focal acute ischemia of intestine, part unspecified

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K55052 Diffuse acute ischemia of intestine, part unspecified

K55059 Acute ischemia of intestine, part and extent unspecified

K55062 Diffuse acute infarction of intestine, part unspecified

K559 Vascular disorder of intestine, unspecified

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Perirectal Abscess

1. Fournier gangrene (N493 or N7689) OR

2. Perianal/perirectal abscess (left column) AND other necrotizing infection (A480, I96, M726)

K610

Anal abscess Fournier:

K611

Rectal abscess N493 Fournier gangrene

K612 Anorectal abscess N7689 Other specified inflammation of vagina and vulva

K613 Ischiorectal abscess Other necrotizing infection:

K614 Intrasphincteric abscess

A480

Gas gangrene

I96 Gangrene, not elsewhere classified

M726 Necrotizing fasciitis

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Hernia

(Inguinal, femoral, umbilical, incisional, ventral, diaphragmatic) Not Complex:

Abdominal hernia without incarceration or gangrene:

Complex

K4020

Bilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent

K4000

Bilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent K4021

Bilateral inguinal hernia, without obstruction or gangrene, recurrent

K4001

Bilateral inguinal hernia, with obstruction, without gangrene, recurrent

K4090

Unilateral inguinal hernia, without obstruction or gangrene, not specified as recurrent

K4030

Unilateral inguinal hernia, with obstruction, without gangrene, not specified as recurrent K4091

Unilateral inguinal hernia, without obstruction or gangrene, recurrent

K4031

Unilateral inguinal hernia, with obstruction, without gangrene, recurrent

K4120

Bilateral femoral hernia, without obstruction or gangrene, not specified as recurrent

K4100

Bilateral femoral hernia, with obstruction, without gangrene, not specified as recurrent K4121

Bilateral femoral hernia, without obstruction or gangrene, recurrent

K4101

Bilateral femoral hernia, with obstruction, without gangrene, recurrent

K4190

Unilateral femoral hernia, without obstruction or gangrene, not specified as recurrent

K4130

Unilateral femoral hernia, with obstruction, without gangrene, not specified as recurrent K4191

Unilateral femoral hernia, without obstruction or gangrene, recurrent

K4131

Unilateral femoral hernia, with obstruction, without gangrene, recurrent

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K429

Umbilical hernia without obstruction or gangrene

K420

Umbilical hernia with

obstruction, without gangrene K432

Incisional hernia without obstruction or gangrene

K430

Incisional hernia with

obstruction, without gangrene K435

Parastomal hernia without obstruction or gangrene

K433

Parastomal hernia with obstruction, without gangrene K439

Ventral hernia without obstruction or gangrene

K436

Other and unspecified ventral hernia with obstruction, without gangrene

K449

Diaphragmatic hernia without obstruction or gangrene

K440

Diaphragmatic hernia with obstruction, without gangrene K458

Other specified abdominal hernia without obstruction or gangrene

K450

Other specified abdominal hernia with obstruction, without gangrene

K469

Unspecified abdominal hernia without obstruction or gangrene

K460

Unspecified abdominal hernia with obstruction, without gangrene

K4010

Bilateral inguinal hernia, with gangrene, not specified as recurrent

K4011

Bilateral inguinal hernia, with gangrene, recurrent

K4040

Unilateral inguinal hernia, with gangrene, not specified as recurrent

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K4041

Unilateral inguinal hernia, with gangrene, recurrent

K4110

Bilateral femoral hernia, with gangrene, not specified as recurrent

K4111

Bilateral femoral hernia, with gangrene, recurrent

K4140

Unilateral femoral hernia, with gangrene, not specified as recurrent

K4141

Unilateral femoral hernia, with gangrene, recurrent

K421

Umbilical hernia with gangrene K431

Incisional hernia with gangrene K434

Parastomal hernia with gangrene

K437

Other and unspecified ventral hernia with gangrene

K441

Diaphragmatic hernia with gangrene

K451

Other specified abdominal hernia with gangrene

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K461

Unspecified abdominal hernia with gangrene

(27)

References

Scott JW, Staudenmayer K, Sangji N, Fan Z, Hemmila M, Utter G. Evaluating the association between American Association for the Surgery of Trauma emergency general surgery anatomic severity grades and clinical outcomes using national claims data. J Trauma Acute Care Surg.

2021;90(2):296-304.

Utter GH, Miller PR, Mowery NT, Tominaga GT, Gunter O, Osler TM, Ciesla DJ, Agarwal SK, Jr., Inaba K, Aboutanos MB, et al. ICD-9-CM and ICD-10-CM mapping of the AAST

Emergency General Surgery disease severity grading systems: Conceptual approach, limitations, and recommendations for the future. J Trauma Acute Care Surg. 2015;78(5):1059-65.