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K68.12 ICD-10-CM Code: Psoas muscle abscess

Compare with another code for K68.12Check this code on a claim

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 33

What these terms mean →

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too, and is marked with where it comes from.

The tabular list publishes no instructional note for this code itself.

Where it sits Source: CMS/NCHS

Under:Chapter 11: Diseases of the Digestive SystemK65-K6A Diseases of peritoneum, retroperitoneum and pelvisK68 Disorders of retroperitoneumK68.1 Retroperitoneal abscess

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Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, Appendix B.

  • MS-DRG 371 — MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC (MDC 06)
  • MS-DRG 372 — MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC (MDC 06)
  • MS-DRG 373 — MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC (MDC 06)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 78 — Intestinal Obstruction/Perforation

Other models: CMS-HCC V22 HCC 33

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Psoas muscle abscess is a billable ICD-10-CM diagnosis code (K68.12).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Verify Before Coding

  • MCC as a secondary diagnosis (FY2027). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name K68.12 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: K65 — Peritonitis (via K68.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 1 Excludes2 note: K6A.0 — Pelvic abscess (via K68.1.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 226 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 371 (MDC 06), DRG 372 (MDC 06), DRG 373 (MDC 06), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG016 — Peritonitis and intra-abdominal abscess (default); MUS026 — Muscle disorders.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

M60.000 — Infective myositis, unspecified right arm, M60.001 — Infective myositis, unspecified left arm, M60.002 — Infective myositis, unspecified arm, M60.003 — Infective myositis, unspecified right leg, M60.004 — Infective myositis, unspecified left leg, M60.005 — Infective myositis, unspecified leg, M60.009 — Infective myositis, unspecified site, M60.011 — Infective myositis, right shoulder, M60.012 — Infective myositis, left shoulder, M60.019 — Infective myositis, unspecified shoulder, M60.021 — Infective myositis, right upper arm, M60.022 — Infective myositis, left upper arm, M60.029 — Infective myositis, unspecified upper arm, M60.031 — Infective myositis, right forearm, M60.032 — Infective myositis, left forearm, M60.039 — Infective myositis, unspecified forearm, M60.041 — Infective myositis, right hand, M60.042 — Infective myositis, left hand, M60.043 — Infective myositis, unspecified hand, M60.044 — Infective myositis, right finger(s), +205 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Intestinal Obstruction/Perforation) for risk-adjusted payment.

K59.31 — Toxic megacolon, K63.1 — Perforation of intestine (nontraumatic), K65.0 — Generalized (acute) peritonitis, K65.1 — Peritoneal abscess, K65.2 — Spontaneous bacterial peritonitis, K65.3 — Choleperitonitis, K65.4 — Sclerosing mesenteritis, K65.8 — Other peritonitis, K65.9 — Peritonitis, unspecified, K67 — Disorders of peritoneum in infectious diseases classified elsewhere, K68.19 — Other retroperitoneal abscess, P77.1 — Stage 1 necrotizing enterocolitis in newborn, P77.2 — Stage 2 necrotizing enterocolitis in newborn, P77.3 — Stage 3 necrotizing enterocolitis in newborn, P77.9 — Necrotizing enterocolitis in newborn, unspecified, P78.0 — Perinatal intestinal perforation, Q40.0 — Congenital hypertrophic pyloric stenosis, Q41.0 — Congenital absence, atresia and stenosis of duodenum, Q41.1 — Congenital absence, atresia and stenosis of jejunum, Q41.2 — Congenital absence, atresia and stenosis of ileum, +55 more

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Intestine Transplant Status/Complications

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Peritonitis and intra-abdominal abscess, Muscle disorders).

K61.0 — Anal abscess, K61.1 — Rectal abscess, K61.2 — Anorectal abscess, K61.3 — Ischiorectal abscess, K61.31 — Horseshoe abscess, K61.39 — Other ischiorectal abscess, K61.4 — Intrasphincteric abscess, K61.5 — Supralevator abscess, K63.0 — Abscess of intestine, K65.0 — Generalized (acute) peritonitis, K65.1 — Peritoneal abscess, K65.2 — Spontaneous bacterial peritonitis, K65.3 — Choleperitonitis, K65.4 — Sclerosing mesenteritis, K65.8 — Other peritonitis, K65.9 — Peritonitis, unspecified, K67 — Disorders of peritoneum in infectious diseases classified elsewhere, K68.11 — Postprocedural retroperitoneal abscess, K68.19 — Other retroperitoneal abscess, K75.0 — Abscess of liver, +430 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Abscess”; these codes share that main term but sit in a different category of the Tabular List.

K57.81 — Diverticulitis of intestine, part unspecified, with perforation and abscess with bleeding (with, diverticular disease, with bleeding), K61.0 — Anal abscess (anus), K61.1 — Rectal abscess (rectum), K61.2 — Anorectal abscess (anorectal), K61.31 — Horseshoe abscess (horseshoe), K61.39 — Other ischiorectal abscess (ischiorectal), K61.4 — Intrasphincteric abscess (intersphincteric), K61.5 — Supralevator abscess (supralevator), K63.0 — Abscess of intestine (colon), K65.1 — Peritoneal abscess (omentum), K6A.01 — Prevesical abscess (retropubic), K6A.09 — Other pelvic abscess (pelvis, pelvic), K75.0 — Abscess of liver (liver), K81.0 — Acute cholecystitis (gallbladder), K94.02 — Colostomy infection (colostomy), K94.12 — Enterostomy infection (ileostomy), L02.01 — Cutaneous abscess of face (chin), L02.11 — Cutaneous abscess of neck (neck), L02.211 — Cutaneous abscess of abdominal wall (loin), L02.212 — Cutaneous abscess of back [any part, except buttock and flank] (back), +157 more

Contextual Map

Every relationship of K68.12 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K68.12 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • K65 — Peritonitis[Excludes1](via K68.-): “retroperitoneal infections (K68.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Excludes2 notes

  • K6A.0 — Pelvic abscess[Excludes2](via K68.1.-): “retroperitoneal abscess (K68.1-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 78 — Intestinal Obstruction/Perforation [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

MDC crossing

  • MDC 06 — Diseases and Disorders of the Digestive System[MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,748 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Abscess (connective tissue) (embolic) (fistulous) (infective) (metastatic) (multiple) (pernicious) (pyogenic) (septic), psoas muscle[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (1)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder-derived relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder editorial explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "K68.12 — Psoas muscle abscess." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k68.12-psoas-muscle-abscess

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Psoas muscle abscess

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K68.12 in its code family, with their registry titles.

View all codes in the K68 family