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ICD-10 Guide
ICD-10 CodesK51.81

K51.81

Non-billable

Other ulcerative colitis with complications

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

Code Description

ICD-10 K51.81 is a used to indicate a diagnosis of other ulcerative colitis with complications.

Key Diagnostic Point:

K51.81 refers to other ulcerative colitis with complications, a subtype of inflammatory bowel disease (IBD) characterized by chronic inflammation of the colonic mucosa. Clinically, patients may present with symptoms such as abdominal pain, diarrhea (often bloody), urgency, and weight loss. The complications associated with this condition can include severe dehydration, toxic megacolon, perforation of the colon, and increased risk of colorectal cancer. The anatomy involved primarily includes the colon and rectum, with inflammation potentially affecting any segment of the colon. Disease progression can vary; some patients may experience intermittent flare-ups, while others may have a more chronic course. Diagnostic considerations include a thorough patient history, physical examination, laboratory tests (such as complete blood count and inflammatory markers), and imaging studies (like colonoscopy with biopsy) to confirm the diagnosis and assess the extent of the disease. Regular monitoring is essential for managing complications and adjusting treatment plans accordingly.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation and differential diagnosis to rule out other gastrointestinal disorders.
  • Treatment complexity: Management may involve medications such as corticosteroids, immunosuppressants, and biologics, as well as potential surgical interventions.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and any complications.
  • Coding specificity: Requires precise coding to differentiate from other types of ulcerative colitis and related gastrointestinal conditions.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of ulcerative colitis or failure to document complications.
  • Documentation gaps: Incomplete records that do not adequately capture the severity or complications of the disease.
  • Billing challenges: Potential for denials if documentation does not clearly support the diagnosis and associated complications.

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

Internal Medicine

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

Ulcerative colitis significantly impacts population health, with rising prevalence rates observed globally. The condition can lead to increased healthcare utilization, including frequent hospitalizations and surgeries, which places a burden on healthcare systems. Quality measures for managing ulcerative colitis focus on controlling symptoms, preventing complications, and improving patients' quality of life. Epidemiologically, understanding the demographics and risk factors associated with ulcerative colitis can help in developing targeted interventions and improving patient outcomes.

ICD-9 vs ICD-10

Ulcerative colitis significantly impacts population health, with rising prevalence rates observed globally. The condition can lead to increased healthcare utilization, including frequent hospitalizations and surgeries, which places a burden on healthcare systems. Quality measures for managing ulcerative colitis focus on controlling symptoms, preventing complications, and improving patients' quality of life. Epidemiologically, understanding the demographics and risk factors associated with ulcerative colitis can help in developing targeted interventions and improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for pre-authorization for certain medications and procedures, as well as adherence to payer-specific guidelines for ulcerative colitis management.

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 K51.81?

K51.81 encompasses ulcerative colitis with complications such as severe dehydration, toxic megacolon, and perforation. It is essential to document the specific complications present to justify the use of this code.

When should K51.81 be used instead of related codes?

K51.81 should be used when the patient has ulcerative colitis with documented complications. If there are no complications, codes like K51.00 or K51.01 may be more appropriate.

What documentation supports K51.81?

Documentation should include clinical findings, results from diagnostic tests (e.g., colonoscopy), treatment plans, and notes on any complications that arise during the patient's care.