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ICD-10 Guide
ICD-10 CodesK51.511

K51.511

Billable

Left sided colitis with rectal bleeding

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

Code Description

ICD-10 K51.511 is a billable code used to indicate a diagnosis of left sided colitis with rectal bleeding.

Key Diagnostic Point:

K51.511 refers to left-sided colitis with rectal bleeding, a subtype of ulcerative colitis that primarily affects the left side of the colon, including the descending colon and rectum. Clinically, patients may present with symptoms such as abdominal pain, diarrhea, and rectal bleeding, which can vary in severity. The anatomy involved includes the colon, particularly the left colon, and the rectum, where inflammation can lead to ulceration and bleeding. Disease progression can be variable; some patients may experience acute exacerbations while others may have a more chronic course. Diagnostic considerations include a thorough clinical history, physical examination, and confirmatory tests such as colonoscopy with biopsy to assess the extent of inflammation and rule out other conditions. Laboratory tests may also be performed to evaluate for anemia or infection. Early diagnosis and management are crucial to prevent complications such as severe bleeding or toxic megacolon.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation and differentiation from other gastrointestinal disorders.
  • Treatment complexity: Management may involve medications such as corticosteroids, immunosuppressants, or biologics, and in severe cases, surgical intervention.
  • Documentation requirements: Detailed documentation of symptoms, diagnostic tests, and treatment plans is essential.
  • Coding specificity: Requires accurate coding to reflect the specific type of colitis and associated symptoms.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of colitis or failure to document rectal bleeding.
  • Documentation gaps: Incomplete clinical notes that do not clearly outline the diagnosis or treatment plan.
  • Billing challenges: Potential denials due to lack of specificity or insufficient documentation to 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

K51.511 has significant clinical implications as it affects a substantial portion of the population with inflammatory bowel disease. The condition can lead to increased healthcare utilization due to frequent hospitalizations and outpatient visits for management. Quality measures focus on timely diagnosis and effective treatment to improve patient outcomes. Understanding the epidemiology of left-sided colitis can help healthcare providers implement preventive strategies and manage the condition more effectively.

ICD-9 vs ICD-10

K51.511 has significant clinical implications as it affects a substantial portion of the population with inflammatory bowel disease. The condition can lead to increased healthcare utilization due to frequent hospitalizations and outpatient visits for management. Quality measures focus on timely diagnosis and effective treatment to improve patient outcomes. Understanding the epidemiology of left-sided colitis can help healthcare providers implement preventive strategies and manage the condition more effectively.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the services provided, such as colonoscopy or medical management. Common denials may arise from insufficient documentation or lack of specificity in the diagnosis. Best practices include maintaining comprehensive clinical notes, ensuring that all symptoms and diagnostic tests are well-documented, and using appropriate modifiers when necessary to avoid billing issues.

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 K51.511?

K51.511 specifically covers left-sided colitis characterized by inflammation of the left colon and rectum, accompanied by rectal bleeding. It is a subtype of ulcerative colitis and may present with symptoms such as abdominal pain, diarrhea, and significant rectal bleeding.

When should K51.511 be used instead of related codes?

K51.511 should be used when there is clear documentation of left-sided colitis with rectal bleeding. It is important to differentiate it from other forms of ulcerative colitis or inflammatory bowel disease that do not specify the location or presence of rectal bleeding.

What documentation supports K51.511?

Documentation should include a detailed clinical history, physical examination findings, results from diagnostic tests such as colonoscopy, and any treatment plans. Specific notes on the presence of rectal bleeding and the extent of colonic involvement are critical.