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ICD-10 Guide
ICD-10 CodesK51.418

K51.418

Billable

Inflammatory polyps of colon with other complication

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

Code Description

ICD-10 K51.418 is a billable code used to indicate a diagnosis of inflammatory polyps of colon with other complication.

Key Diagnostic Point:

K51.418 refers to inflammatory polyps of the colon with other complications, which are benign growths that arise from the mucosal lining of the colon. These polyps can develop as a result of chronic inflammatory conditions such as ulcerative colitis or Crohn's disease. Clinically, patients may present with symptoms such as rectal bleeding, abdominal pain, diarrhea, or changes in bowel habits. The anatomy involved primarily includes the colon, specifically the areas affected by inflammation. Disease progression can lead to complications such as obstruction, perforation, or an increased risk of colorectal cancer, particularly if the polyps are dysplastic. Diagnostic considerations include colonoscopy for direct visualization and biopsy of the polyps, along with imaging studies to assess the extent of disease. Regular surveillance is crucial for patients with inflammatory bowel disease to monitor for the development of polyps and associated complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation through endoscopy and histopathological examination.
  • Treatment complexity: Management may involve surveillance, medical therapy for underlying conditions, or surgical intervention.
  • Documentation requirements: Detailed clinical documentation is essential to justify the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other types of polyps and complications.

Audit Risk Factors

  • Common coding errors: Misclassification of polyps or failure to document complications.
  • Documentation gaps: Incomplete clinical notes regarding the patient's history and treatment.
  • Billing challenges: Potential denials due to lack of supporting documentation for 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

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 K51.418 lies in its association with chronic inflammatory conditions that can lead to serious complications, impacting population health through increased healthcare utilization for surveillance and treatment. Quality measures focus on the timely diagnosis and management of inflammatory bowel disease to prevent complications. Epidemiologically, the prevalence of inflammatory bowel diseases is rising, necessitating awareness and appropriate coding to ensure effective patient care.

ICD-9 vs ICD-10

The clinical significance of K51.418 lies in its association with chronic inflammatory conditions that can lead to serious complications, impacting population health through increased healthcare utilization for surveillance and treatment. Quality measures focus on the timely diagnosis and management of inflammatory bowel disease to prevent complications. Epidemiologically, the prevalence of inflammatory bowel diseases is rising, necessitating awareness and appropriate coding to ensure effective patient care.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of procedures like colonoscopy and any associated treatments. Common denials may arise from insufficient documentation of the diagnosis or complications. Best practices include ensuring that all clinical findings are well-documented and that the coding accurately reflects the complexity of the patient's condition.

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 K51.418?

K51.418 covers inflammatory polyps associated with inflammatory bowel diseases such as ulcerative colitis and Crohn's disease, particularly when there are complications like obstruction or dysplasia.

When should K51.418 be used instead of related codes?

K51.418 should be used when inflammatory polyps are present alongside complications. If there are no complications, K51.419 would be more appropriate.

What documentation supports K51.418?

Documentation should include the patient's history of inflammatory bowel disease, results from colonoscopy and biopsy, and any complications observed during treatment.