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ICD-10 Guide
ICD-10 CodesK51.411

K51.411

Billable

Inflammatory polyps of colon with rectal bleeding

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

Code Description

ICD-10 K51.411 is a billable code used to indicate a diagnosis of inflammatory polyps of colon with rectal bleeding.

Key Diagnostic Point:

K51.411 refers to inflammatory polyps of the colon that are associated with rectal bleeding. Inflammatory polyps are typically benign lesions that arise in the gastrointestinal tract, particularly in the colon, as a result of chronic inflammation. They can occur in conditions such as ulcerative colitis, where the mucosal lining of the colon becomes inflamed and ulcerated, leading to polyp formation. Clinically, patients may present with symptoms such as rectal bleeding, abdominal pain, diarrhea, and changes in bowel habits. The anatomy involved includes the colon and rectum, which are part of the lower gastrointestinal tract. Disease progression can vary; while inflammatory polyps are generally non-cancerous, they can be associated with underlying inflammatory bowel diseases that may increase the risk of colorectal cancer over time. Diagnostic considerations include colonoscopy for direct visualization and biopsy of the polyps, along with imaging studies to assess the extent of inflammation and rule out malignancy. Histopathological examination is crucial for confirming the diagnosis and differentiating inflammatory polyps from other types of polyps or lesions.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation and differentiation from other colorectal conditions.
  • Treatment complexity: Management may involve medical therapy for underlying inflammatory bowel disease and potential surgical intervention.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to capture the specific nature of the polyps and associated symptoms.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of polyp or failure to document rectal bleeding.
  • Documentation gaps: Incomplete records regarding the patient's history of inflammatory bowel disease.
  • Billing challenges: Potential denials if the relationship between the inflammatory polyps and rectal bleeding is not clearly established.

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

Pathology

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

The clinical significance of K51.411 lies in its association with inflammatory bowel diseases, which can lead to serious complications if not managed appropriately. Population health impact includes the need for regular monitoring and management of patients with inflammatory polyps to prevent progression to colorectal cancer. Quality measures may focus on the timely diagnosis and treatment of rectal bleeding and the management of underlying inflammatory conditions, influencing healthcare utilization patterns and resource allocation in gastroenterology.

ICD-9 vs ICD-10

The clinical significance of K51.411 lies in its association with inflammatory bowel diseases, which can lead to serious complications if not managed appropriately. Population health impact includes the need for regular monitoring and management of patients with inflammatory polyps to prevent progression to colorectal cancer. Quality measures may focus on the timely diagnosis and treatment of rectal bleeding and the management of underlying inflammatory conditions, influencing healthcare utilization patterns and resource allocation in gastroenterology.

Reimbursement & Billing Impact

The clinical significance of K51.411 lies in its association with inflammatory bowel diseases, which can lead to serious complications if not managed appropriately. Population health impact includes the need for regular monitoring and management of patients with inflammatory polyps to prevent progression to colorectal cancer. Quality measures may focus on the timely diagnosis and treatment of rectal bleeding and the management of underlying inflammatory conditions, influencing healthcare utilization patterns and resource allocation in gastroenterology.

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 K51.411?

K51.411 specifically covers inflammatory polyps of the colon that are associated with rectal bleeding, primarily arising in the context of inflammatory bowel diseases such as ulcerative colitis.

When should K51.411 be used instead of related codes?

K51.411 should be used when there is clear documentation of inflammatory polyps in the colon accompanied by rectal bleeding, differentiating it from codes that do not specify bleeding or other types of polyps.

What documentation supports K51.411?

Documentation must include a detailed clinical history, findings from colonoscopy, biopsy results confirming inflammatory polyps, and notes on any associated symptoms such as rectal bleeding.