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ICD-10 Guide
ICD-10 CodesK51.514

K51.514

Billable

Left sided colitis with abscess

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

Code Description

ICD-10 K51.514 is a billable code used to indicate a diagnosis of left sided colitis with abscess.

Key Diagnostic Point:

K51.514 refers to left-sided colitis with abscess, a specific form of inflammatory bowel disease (IBD) that primarily affects the descending colon and rectum. Clinically, patients may present with symptoms such as abdominal pain, diarrhea (often bloody), weight loss, and fever. The presence of an abscess indicates a localized collection of pus that can arise due to severe inflammation or infection in the colonic tissue. The anatomy involved includes the left side of the colon, particularly the sigmoid colon and rectum, where inflammation can lead to complications such as strictures or perforation. Disease progression can vary; some patients may experience acute exacerbations while others may have chronic symptoms. Diagnostic considerations include colonoscopy with biopsy, imaging studies like CT scans to identify abscess formation, and laboratory tests to assess inflammatory markers. Early diagnosis and appropriate management are crucial to prevent complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and possibly invasive procedures for accurate diagnosis.
  • Treatment complexity: May involve medications such as corticosteroids, immunosuppressants, or surgical intervention if abscesses are present.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other types of colitis and gastrointestinal disorders.

Audit Risk Factors

  • Common coding errors: Misclassification of colitis types or failure to document abscess presence.
  • Documentation gaps: Incomplete clinical notes or lack of imaging reports can lead to coding inaccuracies.
  • Billing challenges: Potential for denials if documentation does not clearly support the diagnosis and treatment provided.

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

General Surgery

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

K51.514 has significant clinical implications as it indicates a severe form of colitis that can lead to complications such as perforation or sepsis if not managed appropriately. The population health impact is notable, as inflammatory bowel diseases like this are increasing in prevalence, affecting quality of life and healthcare utilization patterns. Effective management of K51.514 can improve patient outcomes and reduce the burden on healthcare systems, highlighting the importance of accurate coding and documentation in the management of gastrointestinal disorders.

ICD-9 vs ICD-10

K51.514 has significant clinical implications as it indicates a severe form of colitis that can lead to complications such as perforation or sepsis if not managed appropriately. The population health impact is notable, as inflammatory bowel diseases like this are increasing in prevalence, affecting quality of life and healthcare utilization patterns. Effective management of K51.514 can improve patient outcomes and reduce the burden on healthcare systems, highlighting the importance of accurate coding and documentation in the management of gastrointestinal disorders.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of care provided, with potential for higher reimbursement rates for cases requiring surgical intervention. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for the procedures performed. Adhering to coding best practices, such as using the most specific codes and ensuring accurate documentation, can mitigate these challenges.

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 K51.514?

K51.514 specifically covers left-sided colitis characterized by inflammation of the left colon with the presence of an abscess. This condition is part of the broader category of ulcerative colitis and may include complications such as severe abdominal pain, fever, and systemic signs of infection.

When should K51.514 be used instead of related codes?

K51.514 should be used when there is clear documentation of left-sided colitis accompanied by an abscess. If the abscess is not present, K51.511 should be used instead. Accurate differentiation is crucial for appropriate treatment and billing.

What documentation supports K51.514?

Documentation should include clinical findings from physical examinations, imaging studies confirming the presence of an abscess, laboratory results indicating inflammation, and treatment plans that reflect the severity of the condition.