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ICD-10 Guide
ICD-10 CodesK51.018

K51.018

Billable

Ulcerative (chronic) pancolitis with other complication

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K51.018 is a billable code used to indicate a diagnosis of ulcerative (chronic) pancolitis with other complication.

Key Diagnostic Point:

Ulcerative pancolitis is a chronic inflammatory bowel disease characterized by inflammation and ulceration of the colonic mucosa. This condition affects the entire colon, leading to symptoms such as abdominal pain, diarrhea (often bloody), and urgency. The disease can progress through various stages, with patients experiencing periods of remission and exacerbation. The anatomy involved includes the entire colon, which may show varying degrees of inflammation, ulceration, and potential complications such as toxic megacolon or perforation. Diagnostic considerations for K51.018 include endoscopic evaluation, histological examination of biopsy samples, and imaging studies to assess the extent of disease and rule out other gastrointestinal disorders. The presence of other complications, such as abscess formation or severe dehydration, necessitates careful monitoring and management to prevent further morbidity.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation including endoscopy and histopathology.
  • Treatment complexity: May involve immunosuppressive therapies, biologics, and surgical interventions.
  • Documentation requirements: Detailed clinical notes and diagnostic imaging reports are essential.
  • Coding specificity: Requires precise documentation of complications and disease extent.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcerative colitis severity or complications.
  • Documentation gaps: Incomplete clinical notes regarding the extent of disease and complications.
  • Billing challenges: Potential denials due to insufficient documentation supporting the diagnosis.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Ulcerative pancolitis significantly impacts population health, contributing to increased healthcare utilization due to frequent hospitalizations and the need for ongoing management. Quality measures focus on controlling disease activity and preventing complications, which can lead to improved patient outcomes. Epidemiologically, ulcerative colitis is prevalent in various demographics, necessitating awareness and effective management strategies to reduce its burden on healthcare systems.

ICD-9 vs ICD-10

Ulcerative pancolitis significantly impacts population health, contributing to increased healthcare utilization due to frequent hospitalizations and the need for ongoing management. Quality measures focus on controlling disease activity and preventing complications, which can lead to improved patient outcomes. Epidemiologically, ulcerative colitis is prevalent in various demographics, necessitating awareness and effective management strategies to reduce its burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement may vary based on the severity of the condition and the complexity of treatment provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the services rendered. Coders should ensure that all relevant clinical information is captured in the medical record, including treatment plans and follow-up care, to support the billing process effectively.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K51.018?

K51.018 covers ulcerative pancolitis with other complications, including but not limited to toxic megacolon, abscesses, or severe dehydration. It is essential to document the specific complications present to justify the use of this code.

When should K51.018 be used instead of related codes?

K51.018 should be used when the patient has confirmed ulcerative pancolitis affecting the entire colon with documented complications. If there are no complications, K51.00 may be more appropriate.

What documentation supports K51.018?

Documentation should include clinical findings, endoscopic reports, biopsy results, and any imaging studies that confirm the diagnosis and detail the complications associated with the condition.