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ICD-10 Guide
ICD-10 CodesK51.90

K51.90

Billable

Ulcerative colitis, unspecified, without complications

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

Code Description

ICD-10 K51.90 is a billable code used to indicate a diagnosis of ulcerative colitis, unspecified, without complications.

Key Diagnostic Point:

Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by inflammation and ulceration of the colonic mucosa. The condition primarily affects the rectum and can extend proximally to involve the entire colon. Patients typically present with symptoms such as abdominal pain, diarrhea (often bloody), urgency to defecate, and weight loss. The disease can vary in severity and may lead to complications such as colonic perforation or toxic megacolon, although K51.90 specifically denotes cases without complications. The pathophysiology involves an inappropriate immune response to intestinal microbiota, leading to chronic inflammation. Diagnosis is often confirmed through colonoscopy and histological examination of biopsy samples. Imaging studies may also be utilized to assess the extent of the disease. Regular monitoring is crucial due to the increased risk of colorectal cancer associated with long-standing ulcerative colitis. Treatment typically involves anti-inflammatory medications, immunosuppressants, and in some cases, surgical intervention. Understanding the clinical presentation and progression of ulcerative colitis is essential for effective management and coding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation and exclusion of other gastrointestinal disorders.
  • Treatment complexity: Involves a range of therapies from medication to potential surgery.
  • Documentation requirements: Detailed clinical notes and diagnostic tests are necessary.
  • Coding specificity: Requires accurate coding to differentiate from other inflammatory bowel diseases.

Audit Risk Factors

  • Common coding errors: Misclassification of ulcerative colitis severity.
  • Documentation gaps: Incomplete clinical notes regarding symptomatology and treatment.
  • Billing challenges: Potential denials due to lack of specificity in documentation.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Ulcerative colitis significantly impacts population health, affecting quality of life and healthcare utilization. It is prevalent in both adults and adolescents, with varying degrees of severity. The chronic nature of the disease often leads to increased healthcare visits, hospitalizations, and the need for long-term management strategies. Quality measures for ulcerative colitis focus on symptom control, disease remission, and monitoring for colorectal cancer, highlighting the importance of effective management and coding practices in improving patient outcomes.

ICD-9 vs ICD-10

Ulcerative colitis significantly impacts population health, affecting quality of life and healthcare utilization. It is prevalent in both adults and adolescents, with varying degrees of severity. The chronic nature of the disease often leads to increased healthcare visits, hospitalizations, and the need for long-term management strategies. Quality measures for ulcerative colitis focus on symptom control, disease remission, and monitoring for colorectal cancer, highlighting the importance of effective management and coding practices in improving patient outcomes.

Reimbursement & Billing Impact

Reimbursement considerations include the need for detailed clinical notes that justify the diagnosis and treatment plan. Common denials may arise from insufficient documentation or lack of specificity in the diagnosis. Coders should ensure that all relevant procedures performed are accurately coded and that any potential complications are clearly documented to avoid billing issues. Adhering to coding best practices is essential for successful claims processing.

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 K51.90?

K51.90 covers unspecified ulcerative colitis without complications. It includes cases where the extent of the disease is not clearly defined, and there are no acute complications such as perforation or severe bleeding.

When should K51.90 be used instead of related codes?

K51.90 should be used when the diagnosis of ulcerative colitis is confirmed but lacks specific details regarding the extent of the disease or when there are no complications present. It is important to differentiate it from codes that specify complications or other forms of inflammatory bowel disease.

What documentation supports K51.90?

Documentation should include a confirmed diagnosis of ulcerative colitis, clinical symptoms, results from colonoscopy and biopsy, and a treatment plan. It is essential to note the absence of complications to justify the use of K51.90.