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2025 ICD-10-CM code K51.414

This code signifies inflammatory polyps in the colon accompanied by an abscess.

Consult the official ICD-10-CM coding guidelines for the most up-to-date information on coding practices. Pay close attention to the Excludes1 and Excludes2 notes associated with K51.414 to avoid incorrect coding.Always ensure complete documentation supporting the diagnosis.

Modifiers may be applicable depending on the circumstances of the service. Consult the CMS guidelines and local payer requirements.

Medical necessity is established when the presence of inflammatory polyps and an abscess in the colon is documented, posing a risk of infection, perforation, or obstruction.The necessity for intervention (medical or surgical) should be justified based on the patient's clinical presentation and the severity of the condition.

The clinical responsibility for this code falls upon gastroenterologists or colorectal surgeons.They are responsible for diagnosing the condition through colonoscopy or other imaging techniques, and determining the need for surgical or medical intervention to manage the abscess and polyps.

IMPORTANT:Related codes include other specifications within the K51.41 range detailing various complications associated with inflammatory polyps of the colon, such as rectal bleeding (K51.411), intestinal obstruction (K51.412), fistula (K51.413), and other unspecified complications (K51.418, K51.419).Codes from other chapters might be necessary to fully capture co-morbidities or related conditions.

In simple words: This medical code is for when someone has inflamed growths (polyps) in their large intestine (colon), and there's also a pus-filled pocket (abscess) nearby.

K51.414, in the ICD-10-CM coding system, specifies inflammatory polyps located within the colon, further characterized by the presence of an abscess.This code is used to classify instances where inflammation causes polyp formation in the colon, and an abscess has developed as a complication.The presence of both the inflammatory polyps and the abscess must be documented for accurate coding.Additional codes may be necessary to identify other co-morbidities or complications.Excludes notes clarify that this code is not applicable for adenomatous polyps of the colon (D12.6), polyposis of the colon (D12.6), or unspecified polyps of the colon (K63.5).Crohn's disease (K50.-) is also excluded.

Example 1: A 55-year-old female presents with abdominal pain, fever, and changes in bowel habits. Colonoscopy reveals inflammatory polyps in the sigmoid colon with an associated abscess.K51.414 is the appropriate code., A 60-year-old male with a history of ulcerative colitis experiences worsening abdominal pain and elevated inflammatory markers.Imaging confirms the presence of inflammatory polyps and an abscess in the ascending colon.K51.414 is used, along with codes reflecting his history of ulcerative colitis., A 40-year-old female undergoing routine colonoscopy has several inflammatory polyps detected in the transverse colon.One polyp has an associated abscess. K51.414 is applied in this instance, along with other codes as necessary to describe the entire findings.

Detailed clinical notes outlining the patient's symptoms, physical examination findings, endoscopic or imaging reports showing the presence of inflammatory polyps and the abscess, and any associated laboratory results such as complete blood count (CBC) and inflammatory markers (CRP, ESR).

** Accurate coding relies heavily on comprehensive documentation from the clinical encounter.Always reference the most current official ICD-10-CM guidelines.

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