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ICD-10 Guide
ICD-10 CodesK51.819

K51.819

Billable

Other ulcerative colitis with unspecified complications

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

Code Description

ICD-10 K51.819 is a billable code used to indicate a diagnosis of other ulcerative colitis with unspecified complications.

Key Diagnostic Point:

K51.819 refers to 'Other ulcerative colitis with unspecified complications,' a subtype of ulcerative colitis (UC), a chronic inflammatory bowel disease affecting the colon and rectum. Clinically, patients may present with symptoms such as abdominal pain, diarrhea (often bloody), urgency, and weight loss. The inflammation primarily involves the mucosal layer of the colon, leading to ulceration and potential complications such as perforation, toxic megacolon, or increased risk of colorectal cancer. Disease progression can vary, with some patients experiencing intermittent flares and periods of remission. Diagnostic considerations include a thorough patient history, physical examination, stool studies, and imaging studies like colonoscopy, which allows for direct visualization of the colon and biopsy of affected areas. The unspecified complications in this code indicate that while the patient has ulcerative colitis, the specific complications are not clearly defined, necessitating careful clinical evaluation to guide management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation to rule out other gastrointestinal disorders.
  • Treatment complexity: Management may involve medications, dietary changes, and possibly surgery.
  • Documentation requirements: Detailed clinical notes are necessary to support the diagnosis and any complications.
  • Coding specificity: Requires accurate coding to differentiate from other types of ulcerative colitis.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcerative colitis types or complications.
  • Documentation gaps: Incomplete clinical notes that do not specify the nature of complications.
  • Billing challenges: Potential denials if documentation does not clearly 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

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

Ulcerative colitis, including cases coded as K51.819, significantly impacts population health due to its chronic nature and potential complications. It affects quality of life, increases healthcare utilization, and can lead to serious health outcomes if not managed effectively. Epidemiologically, ulcerative colitis has been associated with increased risks of colorectal cancer, necessitating ongoing surveillance and management strategies to improve patient outcomes and reduce healthcare costs.

ICD-9 vs ICD-10

Ulcerative colitis, including cases coded as K51.819, significantly impacts population health due to its chronic nature and potential complications. It affects quality of life, increases healthcare utilization, and can lead to serious health outcomes if not managed effectively. Epidemiologically, ulcerative colitis has been associated with increased risks of colorectal cancer, necessitating ongoing surveillance and management strategies to improve patient outcomes and reduce healthcare costs.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear justification of the diagnosis in the medical record to avoid denials. Common billing challenges may arise from insufficient documentation or misclassification of the condition. Best practices include regular audits of coding accuracy and ensuring that all relevant clinical information is captured in the patient's record.

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 K51.819?

K51.819 encompasses cases of ulcerative colitis that do not fit into more specific categories, including those with atypical presentations or complications that are not clearly defined. This may include cases with mild to moderate symptoms without clear complications.

When should K51.819 be used instead of related codes?

K51.819 should be used when the patient's ulcerative colitis is confirmed, but the specific complications are not documented or are unclear. It is essential to differentiate it from codes that specify particular complications or severity.

What documentation supports K51.819?

Documentation should include a detailed patient history, clinical findings, results from diagnostic tests (e.g., colonoscopy), and any treatment plans. Clear notes on the absence of specified complications are also crucial.