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ICD-10 Guide
ICD-10 CodesK51.811

K51.811

Billable

Other ulcerative colitis with rectal bleeding

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

Code Description

ICD-10 K51.811 is a billable code used to indicate a diagnosis of other ulcerative colitis with rectal bleeding.

Key Diagnostic Point:

K51.811 refers to other ulcerative colitis with rectal bleeding, a subtype of inflammatory bowel disease (IBD) characterized by inflammation and ulceration of the colonic mucosa. Clinically, patients may present with symptoms such as abdominal pain, diarrhea, and rectal bleeding, which can vary in severity. The anatomy involved primarily includes the rectum and colon, where inflammation can lead to complications such as strictures or perforation if left untreated. Disease progression can be variable, with periods of exacerbation and remission. Diagnostic considerations include a thorough patient history, physical examination, and confirmatory tests such as colonoscopy with biopsy, which helps differentiate ulcerative colitis from other gastrointestinal conditions like Crohn's disease. Laboratory tests may also be performed to assess inflammation and rule out infections. Accurate diagnosis is crucial for effective management and treatment planning, which may involve medications such as aminosalicylates, corticosteroids, or immunomodulators, and in severe cases, surgical intervention may be necessary.

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 ulcerative colitis types.
  • Documentation gaps may arise if rectal bleeding is not clearly noted in the medical record.
  • Billing challenges can occur if the severity of the condition is not adequately documented.

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

K51.811 has significant clinical implications as ulcerative colitis can lead to severe complications if not managed properly. The prevalence of ulcerative colitis affects population health, with increasing healthcare utilization patterns due to the chronic nature of the disease. Quality measures often focus on the management of symptoms and prevention of complications, highlighting the importance of timely diagnosis and effective treatment strategies.

ICD-9 vs ICD-10

K51.811 has significant clinical implications as ulcerative colitis can lead to severe complications if not managed properly. The prevalence of ulcerative colitis affects population health, with increasing healthcare utilization patterns due to the chronic nature of the disease. Quality measures often focus on the management of symptoms and prevention of complications, highlighting the importance of timely diagnosis and effective treatment strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is supported by clinical evidence and that all relevant procedures are coded accurately. Common denials may arise from insufficient documentation or failure to meet medical necessity criteria. Best practices include maintaining thorough records of patient visits, treatment plans, and any diagnostic tests performed to support the coding and billing process.

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 K51.811?

K51.811 covers cases of ulcerative colitis that are characterized by rectal bleeding, which may present alongside other symptoms such as abdominal pain and diarrhea. It is important to differentiate this from other types of ulcerative colitis that do not present with rectal bleeding.

When should K51.811 be used instead of related codes?

K51.811 should be used when the patient has a confirmed diagnosis of ulcerative colitis with documented rectal bleeding. If rectal bleeding is not present, other codes such as K51.819 should be considered.

What documentation supports K51.811?

Documentation should include a clear diagnosis of ulcerative colitis, evidence of rectal bleeding, and any relevant laboratory or imaging studies. Detailed notes on the patient's symptoms and treatment plan are also essential.