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ICD-10 Guide
ICD-10 CodesK51.4

K51.4

Non-billable

Inflammatory polyps of colon

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

Code Description

ICD-10 K51.4 is a used to indicate a diagnosis of inflammatory polyps of colon.

Key Diagnostic Point:

K51.4 refers to inflammatory polyps of the colon, which are benign growths that arise from the mucosal lining of the colon due to chronic inflammation. These polyps can occur in various gastrointestinal conditions, particularly in patients with inflammatory bowel disease (IBD) such as ulcerative colitis. Clinically, patients may present with symptoms such as rectal bleeding, abdominal pain, and changes in bowel habits. The anatomy involved includes the colon, which is part of the large intestine, and these polyps can develop in any segment of the colon. Disease progression may lead to complications such as obstruction or, in rare cases, dysplasia, which can increase the risk of colorectal cancer. Diagnostic considerations include colonoscopy for direct visualization and biopsy of the polyps, along with imaging studies to assess the extent of inflammation and rule out malignancy. Regular surveillance is essential for patients with a history of inflammatory polyps, especially in the context of IBD, to monitor for potential malignant transformation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassification of polyps as neoplastic rather than inflammatory.
  • Documentation gaps may arise if the chronic nature of the underlying inflammatory condition is not well documented.
  • Billing challenges can occur if the relationship between the inflammatory polyps and the underlying IBD is not clearly established.

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

Pathology

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

The clinical significance of K51.4 lies in its association with inflammatory bowel disease, which affects a significant portion of the population and can lead to serious complications if not monitored. Understanding the epidemiology of inflammatory polyps is crucial for improving patient outcomes and guiding surveillance strategies. Quality measures related to the management of IBD and associated polyps can enhance healthcare utilization patterns and reduce the risk of colorectal cancer in affected populations.

ICD-9 vs ICD-10

The clinical significance of K51.4 lies in its association with inflammatory bowel disease, which affects a significant portion of the population and can lead to serious complications if not monitored. Understanding the epidemiology of inflammatory polyps is crucial for improving patient outcomes and guiding surveillance strategies. Quality measures related to the management of IBD and associated polyps can enhance healthcare utilization patterns and reduce the risk of colorectal cancer in affected populations.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the procedure performed. Common denials may arise from insufficient documentation of the inflammatory nature of the polyps or failure to demonstrate medical necessity for the procedure. Best practices include maintaining thorough records of patient history, symptoms, and procedural outcomes to support claims.

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 K51.4?

K51.4 specifically covers inflammatory polyps that arise in the context of inflammatory bowel diseases, particularly ulcerative colitis. These polyps are distinct from adenomatous polyps and are characterized by their association with chronic inflammation.

When should K51.4 be used instead of related codes?

K51.4 should be used when the polyps are confirmed to be inflammatory and associated with IBD. It is important to differentiate from other polyp types, such as adenomatous or hyperplastic polyps, which have different management and surveillance guidelines.

What documentation supports K51.4?

Documentation should include a clear diagnosis of inflammatory bowel disease, details of the colonoscopy findings, biopsy results confirming the inflammatory nature of the polyps, and any relevant symptoms experienced by the patient.