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ICD-10 Guide
ICD-10 CodesK51.919

K51.919

Billable

Ulcerative colitis, unspecified with unspecified complications

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

Code Description

ICD-10 K51.919 is a billable code used to indicate a diagnosis of ulcerative colitis, unspecified with unspecified 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. Clinical presentation often includes symptoms such as abdominal pain, diarrhea (which may be bloody), urgency to defecate, and weight loss. The etiology of UC remains unclear, but it is believed to involve a combination of genetic, environmental, and immunological factors. Disease progression can vary, with some patients experiencing intermittent flares and periods of remission. Complications may include severe dehydration, toxic megacolon, and an increased risk of colorectal cancer. Diagnostic considerations include a thorough patient history, physical examination, laboratory tests, and imaging studies, along with endoscopic evaluation to visualize the colon and obtain biopsies. The unspecified nature of K51.919 indicates that the specific location of the ulcerative colitis and the nature of any complications have not been documented, necessitating careful clinical assessment to guide management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation to differentiate from other gastrointestinal disorders.
  • Treatment complexity: Management may involve medication, lifestyle changes, and possibly surgery.
  • Documentation requirements: Must clearly document symptoms, diagnostic findings, and treatment plans.
  • Coding specificity: Unspecified code may lead to ambiguity in clinical documentation.

Audit Risk Factors

  • Common coding errors: Misuse of unspecified codes when more specific codes are available.
  • Documentation gaps: Incomplete records that do not adequately describe the patient's condition.
  • Billing challenges: Potential for claim denials if documentation does not 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

Ulcerative colitis significantly impacts patient quality of life and healthcare utilization, leading to frequent medical visits, hospitalizations, and potential surgeries. The prevalence of UC varies globally, with higher rates observed in developed countries. Understanding the epidemiology of UC is crucial for public health initiatives aimed at improving management strategies and patient outcomes. Quality measures related to UC management focus on timely diagnosis, effective treatment, and monitoring for complications, which are essential for optimizing patient care.

ICD-9 vs ICD-10

Ulcerative colitis significantly impacts patient quality of life and healthcare utilization, leading to frequent medical visits, hospitalizations, and potential surgeries. The prevalence of UC varies globally, with higher rates observed in developed countries. Understanding the epidemiology of UC is crucial for public health initiatives aimed at improving management strategies and patient outcomes. Quality measures related to UC management focus on timely diagnosis, effective treatment, and monitoring for complications, which are essential for optimizing patient care.

Reimbursement & Billing Impact

Reimbursement considerations include verifying that the patient's symptoms and treatment align with the code used. Common denials may arise from insufficient documentation or failure to provide evidence of medical necessity. Coders should ensure that all relevant clinical information is included in the patient's medical record to prevent billing issues. Best practices include using specific codes when available and maintaining thorough documentation of the patient's condition and treatment plan.

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 K51.919?

K51.919 covers ulcerative colitis without specifying the extent of the disease or any associated complications. It is used when the clinician has not documented the specific type or severity of ulcerative colitis.

When should K51.919 be used instead of related codes?

K51.919 should be used when the clinical documentation does not specify the type of ulcerative colitis or if complications are not clearly defined. If more specific codes are available and applicable, they should be used to enhance coding accuracy.

What documentation supports K51.919?

Documentation should include a detailed patient history, physical examination findings, laboratory results, imaging studies, and endoscopic evaluations. Clear notes on the absence of specific complications or the extent of the disease are crucial.