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ICD-10 Guide
ICD-10 CodesK51.412

K51.412

Billable

Inflammatory polyps of colon with intestinal obstruction

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

Code Description

ICD-10 K51.412 is a billable code used to indicate a diagnosis of inflammatory polyps of colon with intestinal obstruction.

Key Diagnostic Point:

K51.412 refers to inflammatory polyps of the colon that are accompanied by intestinal obstruction. Inflammatory polyps are benign lesions that arise due to chronic inflammation, often associated with conditions such as ulcerative colitis. The colon, part of the large intestine, is the primary anatomical site affected by these polyps. Patients may present with symptoms such as abdominal pain, rectal bleeding, and changes in bowel habits. The progression of the disease can lead to significant complications, including obstruction, which may require surgical intervention. Diagnostic considerations include colonoscopy, imaging studies, and histopathological examination to differentiate inflammatory polyps from malignant lesions. It is crucial to assess the extent of colonic involvement and the presence of any obstructive pathology to guide treatment and management effectively.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation through imaging and endoscopy.
  • Treatment complexity: May involve medical management or surgical intervention depending on severity.
  • Documentation requirements: Detailed clinical notes and pathology reports are essential.
  • Coding specificity: Requires precise coding to differentiate from other gastrointestinal conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of polyps or failure to document obstruction.
  • Documentation gaps: Incomplete clinical notes regarding the patient's symptoms and treatment.
  • Billing challenges: Potential denials if the medical necessity for procedures 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

Surgery

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 K51.412 lies in its potential to lead to serious complications such as bowel obstruction, which can necessitate surgical intervention. Understanding the epidemiology of inflammatory bowel disease and its associated conditions is vital for population health management. Quality measures may include monitoring the incidence of colorectal complications and ensuring timely interventions to improve patient outcomes. Healthcare utilization patterns may reflect increased resource use in managing patients with this condition, highlighting the importance of effective coding and documentation.

ICD-9 vs ICD-10

The clinical significance of K51.412 lies in its potential to lead to serious complications such as bowel obstruction, which can necessitate surgical intervention. Understanding the epidemiology of inflammatory bowel disease and its associated conditions is vital for population health management. Quality measures may include monitoring the incidence of colorectal complications and ensuring timely interventions to improve patient outcomes. Healthcare utilization patterns may reflect increased resource use in managing patients with this condition, highlighting the importance of effective coding and documentation.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the case and the treatment provided. Common denials can occur if the medical necessity is not well-documented or if the coding does not accurately reflect the services rendered. Adhering to coding best practices and ensuring comprehensive documentation 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 K51.412?

K51.412 specifically covers inflammatory polyps of the colon that are associated with intestinal obstruction. This includes polyps arising from inflammatory bowel disease, particularly ulcerative colitis, where chronic inflammation leads to polyp formation and subsequent obstruction.

When should K51.412 be used instead of related codes?

K51.412 should be used when there is clear documentation of inflammatory polyps in the colon that are causing intestinal obstruction. If the polyps are present without obstruction, K51.411 would be more appropriate. Accurate clinical documentation is essential for correct code selection.

What documentation supports K51.412?

Documentation supporting K51.412 should include a detailed clinical history, physical examination findings, results from imaging studies (like CT scans), colonoscopy reports, and histopathological findings confirming the presence of inflammatory polyps and any evidence of obstruction.