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ICD-10 Guide
ICD-10 CodesK51.814

K51.814

Billable

Other ulcerative colitis with abscess

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

Code Description

ICD-10 K51.814 is a billable code used to indicate a diagnosis of other ulcerative colitis with abscess.

Key Diagnostic Point:

K51.814 refers to 'Other ulcerative colitis with abscess,' a subtype of ulcerative colitis characterized by inflammation and ulceration of the colonic mucosa, leading to the formation of abscesses. This condition primarily affects the large intestine and can result in severe abdominal pain, diarrhea, and rectal bleeding. The disease progression may vary, with some patients experiencing acute exacerbations while others may have chronic symptoms. Diagnostic considerations include colonoscopy, imaging studies, and laboratory tests to assess inflammation and rule out other gastrointestinal disorders. The presence of abscesses indicates a more severe form of the disease, often requiring more aggressive treatment strategies, including corticosteroids, immunosuppressants, or surgical intervention. Early diagnosis and management are crucial to prevent complications such as perforation or toxic megacolon.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation and differentiation from other gastrointestinal conditions.
  • Treatment complexity: May involve multiple treatment modalities including medication and possible surgery.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to capture the specific type of ulcerative colitis and associated complications.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcerative colitis types.
  • Documentation gaps: Incomplete clinical notes regarding abscess presence.
  • Billing challenges: Potential denials due to lack of supporting documentation.

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

K51.814 has significant clinical implications as it indicates a severe form of ulcerative colitis that can lead to serious complications if not managed appropriately. The presence of abscesses may increase healthcare utilization, including hospital admissions and surgical interventions. Understanding the epidemiology of ulcerative colitis and its complications is essential for improving population health outcomes and implementing effective quality measures in patient care.

ICD-9 vs ICD-10

K51.814 has significant clinical implications as it indicates a severe form of ulcerative colitis that can lead to serious complications if not managed appropriately. The presence of abscesses may increase healthcare utilization, including hospital admissions and surgical interventions. Understanding the epidemiology of ulcerative colitis and its complications is essential for improving population health outcomes and implementing effective quality measures in patient care.

Reimbursement & Billing Impact

reimbursement. Providers should ensure that all clinical notes, imaging results, and treatment plans are well-documented and clearly indicate the severity of the ulcerative colitis. Common denials may arise from insufficient documentation or incorrect coding. It is advisable to follow coding best practices, including regular audits and updates on coding guidelines, 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 K51.814?

K51.814 covers ulcerative colitis cases that present with abscess formation, which may occur in the context of severe inflammation and ulceration of the colonic mucosa. This code is used when there is clear documentation of abscesses associated with ulcerative colitis.

When should K51.814 be used instead of related codes?

K51.814 should be used when the patient has ulcerative colitis with documented abscesses. If abscesses are not present, other codes such as K51.811 or K51.812 may be more appropriate, depending on the specific clinical scenario.

What documentation supports K51.814?

Documentation should include clinical findings of ulcerative colitis, imaging or endoscopic evidence of abscess formation, and treatment plans that reflect the severity of the condition. Comprehensive notes from the healthcare provider detailing the patient's symptoms and response to treatment are essential.