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ICD-10 Guide
ICD-10 CodesK51.311

K51.311

Billable

Ulcerative (chronic) rectosigmoiditis with rectal bleeding

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

Code Description

ICD-10 K51.311 is a billable code used to indicate a diagnosis of ulcerative (chronic) rectosigmoiditis with rectal bleeding.

Key Diagnostic Point:

K51.311 refers to ulcerative (chronic) rectosigmoiditis with rectal bleeding, a form of inflammatory bowel disease (IBD) primarily affecting the rectum and sigmoid colon. Clinically, patients may present with symptoms such as abdominal pain, diarrhea (often bloody), urgency, and tenesmus. The rectosigmoid region, which includes the last part of the colon and the rectum, becomes inflamed and ulcerated, leading to significant discomfort and complications. Disease progression can vary; some patients may experience intermittent flare-ups, while others may have a more chronic course with persistent symptoms. Diagnostic considerations include a thorough patient history, physical examination, and confirmatory tests such as colonoscopy with biopsy, which can reveal characteristic mucosal changes. Laboratory tests may also be conducted to assess inflammation and rule out other conditions. Early diagnosis and management are crucial to prevent complications such as severe bleeding or perforation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires detailed clinical evaluation and diagnostic imaging.
  • Treatment complexity: May involve medication management, dietary changes, and in some cases, surgical intervention.
  • Documentation requirements: Detailed clinical notes and diagnostic evidence are necessary for accurate coding.
  • Coding specificity: Requires precise documentation to differentiate from other forms of ulcerative colitis.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcerative colitis types.
  • Documentation gaps: Incomplete clinical notes regarding symptoms and diagnostic tests.
  • Billing challenges: Potential for denials if documentation does not clearly 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

K51.311 has significant clinical implications, as ulcerative rectosigmoiditis can lead to severe complications if not managed properly. It affects a notable portion of the population, particularly young adults, impacting their quality of life and healthcare utilization. Effective management of this condition is crucial for improving patient outcomes, reducing hospitalizations, and enhancing overall population health. Awareness of the epidemiology of IBD, including ulcerative colitis, is essential for healthcare providers to implement preventive measures and optimize care.

ICD-9 vs ICD-10

K51.311 has significant clinical implications, as ulcerative rectosigmoiditis can lead to severe complications if not managed properly. It affects a notable portion of the population, particularly young adults, impacting their quality of life and healthcare utilization. Effective management of this condition is crucial for improving patient outcomes, reducing hospitalizations, and enhancing overall population health. Awareness of the epidemiology of IBD, including ulcerative colitis, is essential for healthcare providers to implement preventive measures and optimize care.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of care provided, and it is essential to use appropriate CPT codes for any procedures performed. Common denials may arise from insufficient documentation or failure to clearly link the diagnosis to the services billed. Adhering to coding best practices and maintaining thorough records 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 K51.311?

K51.311 specifically covers chronic ulcerative rectosigmoiditis characterized by inflammation and ulceration of the rectum and sigmoid colon, accompanied by rectal bleeding. It is a subtype of ulcerative colitis that necessitates careful monitoring and management.

When should K51.311 be used instead of related codes?

K51.311 should be used when the patient presents with chronic ulcerative rectosigmoiditis specifically with rectal bleeding. It is important to differentiate it from other forms of ulcerative colitis that may not involve rectal bleeding or have different anatomical involvement.

What documentation supports K51.311?

Documentation should include a detailed patient history, physical examination findings, results from colonoscopy and biopsy, and any laboratory tests indicating inflammation. Clear notes on the presence of rectal bleeding and chronicity of symptoms are essential.