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ICD-10 Guide
ICD-10 CodesK51.30

K51.30

Billable

Ulcerative (chronic) rectosigmoiditis without complications

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

Code Description

ICD-10 K51.30 is a billable code used to indicate a diagnosis of ulcerative (chronic) rectosigmoiditis without complications.

Key Diagnostic Point:

Ulcerative rectosigmoiditis is a form of inflammatory bowel disease characterized by inflammation and ulceration of the rectum and sigmoid colon. Clinically, patients may present with symptoms such as abdominal pain, diarrhea (often bloody), urgency, and tenesmus. The anatomy involved includes the lower part of the colon, specifically the sigmoid colon and rectum, which are crucial for the final stages of digestion and waste elimination. Disease progression can vary, with some patients experiencing intermittent flare-ups and periods of remission. Chronic cases may lead to complications such as strictures or increased risk of colorectal cancer. Diagnostic considerations include a thorough patient history, physical examination, stool studies, and endoscopic evaluation with biopsy to confirm the diagnosis and rule out other conditions such as Crohn's disease or infectious colitis. Laboratory tests may also be employed to assess inflammation and rule out other gastrointestinal disorders.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis to exclude other gastrointestinal diseases.
  • Treatment complexity: Management may involve medications, dietary changes, and potentially surgery.
  • Documentation requirements: Detailed clinical notes and diagnostic test results are necessary.
  • Coding specificity: Requires precise coding to differentiate from other ulcerative colitis types.

Audit Risk Factors

  • Common coding errors: Misclassification with other types of colitis.
  • Documentation gaps: Incomplete records regarding symptomatology and treatment history.
  • 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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Ulcerative rectosigmoiditis significantly impacts patient quality of life and healthcare utilization, often leading to increased visits to healthcare providers and potential hospitalizations during flare-ups. Understanding the epidemiology of this condition is crucial, as it affects a notable portion of the population, particularly in developed countries. Quality measures related to the management of ulcerative colitis, including K51.30, focus on improving patient outcomes and reducing complications, thereby enhancing overall population health.

ICD-9 vs ICD-10

Ulcerative rectosigmoiditis significantly impacts patient quality of life and healthcare utilization, often leading to increased visits to healthcare providers and potential hospitalizations during flare-ups. Understanding the epidemiology of this condition is crucial, as it affects a notable portion of the population, particularly in developed countries. Quality measures related to the management of ulcerative colitis, including K51.30, focus on improving patient outcomes and reducing complications, thereby enhancing overall population health.

Reimbursement & Billing Impact

reimbursement considerations include the necessity of prior authorizations for certain treatments and the potential for denials if documentation is insufficient. It is advisable to follow coding best practices by using the most specific codes available and ensuring that all claims are supported by adequate clinical evidence.

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 K51.30?

K51.30 specifically covers ulcerative rectosigmoiditis, which is characterized by chronic inflammation and ulceration of the rectum and sigmoid colon without any complications. It is important to differentiate it from other types of ulcerative colitis and gastrointestinal disorders.

When should K51.30 be used instead of related codes?

K51.30 should be used when the patient has a confirmed diagnosis of ulcerative rectosigmoiditis without complications. It is essential to differentiate it from other codes like K51.20, which covers unspecified ulcerative colitis, to ensure accurate representation of the patient's condition.

What documentation supports K51.30?

Documentation for K51.30 should include a detailed clinical history, physical examination findings, results from endoscopic procedures, and any relevant laboratory tests that confirm the diagnosis of ulcerative rectosigmoiditis without complications.