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ICD-10 Guide
ICD-10 CodesK51.3

K51.3

Non-billable

Ulcerative (chronic) rectosigmoiditis

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

Code Description

ICD-10 K51.3 is a used to indicate a diagnosis of ulcerative (chronic) rectosigmoiditis.

Key Diagnostic Point:

Ulcerative (chronic) rectosigmoiditis is a form of inflammatory bowel disease (IBD) characterized by inflammation and ulceration of the rectum and sigmoid colon. Clinically, patients may present with symptoms such as rectal bleeding, diarrhea (often with blood and mucus), abdominal pain, and tenesmus (a feeling of incomplete bowel evacuation). The condition primarily affects the rectosigmoid region, which is the last part of the colon leading into the rectum. Disease progression can vary; some patients may experience intermittent flare-ups, while others may have chronic symptoms that significantly impact their quality of life. Diagnostic considerations include a thorough clinical history, physical examination, and confirmatory tests such as colonoscopy with biopsy, which can help differentiate ulcerative rectosigmoiditis from other forms of colitis. Laboratory tests may also be performed to assess inflammation and rule out infections. Management typically involves medication to reduce inflammation and control symptoms, and in severe cases, surgical intervention may be necessary.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis from other gastrointestinal disorders.
  • Treatment complexity: Involves medication management and potential surgical options.
  • Documentation requirements: Detailed clinical notes and diagnostic tests are essential.
  • Coding specificity: Requires precise coding to differentiate from other types of ulcerative colitis.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of colitis.
  • Documentation gaps: Incomplete clinical notes or lack of supporting diagnostic tests.
  • Billing challenges: Potential denials due to insufficient documentation or incorrect code selection.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Ulcerative (chronic) rectosigmoiditis has significant clinical implications, affecting patient quality of life and healthcare utilization. It is a prevalent condition within the inflammatory bowel disease spectrum, impacting a substantial portion of the population, particularly young adults. Effective management is crucial to reduce complications and improve health outcomes. Quality measures often focus on symptom control, patient education, and regular monitoring to prevent disease progression.

ICD-9 vs ICD-10

Ulcerative (chronic) rectosigmoiditis has significant clinical implications, affecting patient quality of life and healthcare utilization. It is a prevalent condition within the inflammatory bowel disease spectrum, impacting a substantial portion of the population, particularly young adults. Effective management is crucial to reduce complications and improve health outcomes. Quality measures often focus on symptom control, patient education, and regular monitoring to prevent disease progression.

Reimbursement & Billing Impact

Reimbursement considerations include the need for thorough clinical notes, results from diagnostic tests, and adherence to coding guidelines. Common denials may arise from insufficient documentation or incorrect coding, particularly if the condition is not clearly differentiated from other gastrointestinal disorders. Best practices include ensuring that all relevant clinical information is documented and that the coding reflects the specific diagnosis accurately.

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 K51.3?

K51.3 specifically covers chronic ulcerative rectosigmoiditis, which is a localized form of ulcerative colitis affecting the rectum and sigmoid colon. It is characterized by chronic inflammation and ulceration in this area, leading to symptoms such as rectal bleeding and diarrhea.

When should K51.3 be used instead of related codes?

K51.3 should be used when the clinical presentation specifically indicates chronic ulcerative rectosigmoiditis, as opposed to other forms of ulcerative colitis or non-specific colitis. Accurate diagnosis through colonoscopy and biopsy is crucial for appropriate code selection.

What documentation supports K51.3?

Documentation for K51.3 should include a detailed clinical history, physical examination findings, results from colonoscopy and biopsy, and any laboratory tests that support the diagnosis of chronic ulcerative rectosigmoiditis.