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ICD-10 Guide
ICD-10 CodesK51.80

K51.80

Billable

Other ulcerative colitis without complications

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

Code Description

ICD-10 K51.80 is a billable code used to indicate a diagnosis of other ulcerative colitis without complications.

Key Diagnostic Point:

K51.80 refers to 'Other ulcerative colitis without complications,' a subtype of ulcerative colitis (UC), which is a chronic inflammatory bowel disease primarily affecting the colon and rectum. Clinically, patients may present with symptoms such as abdominal pain, diarrhea (often bloody), urgency to defecate, and weight loss. The anatomy involved includes the large intestine, particularly the mucosal layer, which becomes inflamed and ulcerated. Disease progression can vary, with some patients experiencing intermittent flare-ups and periods of remission. Diagnostic considerations include a thorough patient history, physical examination, stool studies, and endoscopic evaluation, such as colonoscopy, which allows for direct visualization and biopsy of the colonic mucosa. The absence of complications, such as severe bleeding or perforation, distinguishes this code from other forms of ulcerative colitis, necessitating careful documentation of the patient's clinical status and any prior treatments.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differentiation from other gastrointestinal disorders.
  • Treatment complexity: May involve medication management and lifestyle modifications.
  • Documentation requirements: Detailed clinical notes and diagnostic tests are essential.
  • Coding specificity: Requires accurate coding to reflect the absence of complications.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcerative colitis types.
  • Documentation gaps: Incomplete clinical notes regarding the patient's condition.
  • Billing challenges: Potential denials if documentation does not support 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

Primary Care

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 colitis, including cases coded as K51.80, significantly impacts population health, affecting quality of life and healthcare utilization. Patients may experience increased healthcare visits, hospitalizations during flare-ups, and long-term management needs. Understanding the epidemiology of ulcerative colitis helps in developing targeted interventions and quality measures to improve patient outcomes.

ICD-9 vs ICD-10

Ulcerative colitis, including cases coded as K51.80, significantly impacts population health, affecting quality of life and healthcare utilization. Patients may experience increased healthcare visits, hospitalizations during flare-ups, and long-term management needs. Understanding the epidemiology of ulcerative colitis helps in developing targeted interventions and quality measures to improve patient outcomes.

Reimbursement & Billing Impact

reimbursement considerations include the patient's insurance policy and the necessity of prior authorizations for certain procedures. It is essential to follow coding best practices, ensuring that the diagnosis is clearly linked to the services provided to minimize billing 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 K51.80?

K51.80 covers cases of ulcerative colitis that do not present with complications such as toxic megacolon, perforation, or severe hemorrhage. It includes patients with mild to moderate symptoms that do not escalate to critical conditions.

When should K51.80 be used instead of related codes?

K51.80 should be used when the patient has a confirmed diagnosis of ulcerative colitis without any complications. If complications are present, such as severe bleeding or perforation, then codes like K51.81 should be utilized.

What documentation supports K51.80?

Documentation should include a detailed clinical history, results from diagnostic tests such as colonoscopy, and any treatment plans. Clear notes indicating the absence of complications are crucial for supporting the use of K51.80.