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2025 ICD-10-CM code K63.3

Ulcer of the intestine.

Consult official ICD-10-CM coding guidelines for accurate coding practices.Ensure appropriate documentation supports the assigned code and that exclusions are carefully considered. The location of the ulcer should be documented appropriately.If the ulcer is associated with a specific disease or condition (like Crohn's disease), that should also be coded.

Modifiers may be applicable depending on the circumstances of the visit and the procedures performed.Consult the most updated modifier guidelines for specific circumstances.

Medical necessity for the treatment of an intestinal ulcer is established by the presence of symptoms that impact the patient's quality of life or pose a risk of complications such as bleeding, perforation, obstruction, or anemia.The severity of symptoms, the response to conservative management, and the potential for complications will be considered when determining the necessity of further intervention like surgery or endoscopy. The documentation must clearly show the medical necessity for any procedures performed.

The clinical responsibility for a patient with K63.3 would rest with a gastroenterologist or general surgeon, depending on the severity and location of the ulcer.Management might involve medication, endoscopic procedures, or surgery, depending on the diagnosis and patient's overall health.The treating physician is responsible for determining the appropriate course of action.

IMPORTANT:This code should not be used if the ulcer is specifically located in the duodenum (K26.-), is a peptic ulcer of unspecified location (K27.-), or affects the anus or rectum (K62.6).Ulcerative colitis (K51.-) is also excluded.

In simple words: This code means there's a sore or ulcer in your intestines.Intestines are the long tubes in your belly that help digest food.

K63.3, Ulcer of intestine, refers to an ulcerative lesion located in the intestinal lining.This code encompasses ulcers affecting any part of the small or large intestine, excluding specifically defined ulcer types like duodenal or peptic ulcers.The ulcer may present with various symptoms depending on location and severity.

Example 1: A 60-year-old male presents with abdominal pain, weight loss, and melena (dark, tarry stools). Colonoscopy reveals a large ulcer in the sigmoid colon. The physician codes this as K63.3., A 35-year-old female with Crohn's disease experiences recurrent episodes of abdominal pain and bloody diarrhea.An endoscopy shows several ulcers in the ileum. The code K63.3 is used., A 72-year-old patient who has a history of diverticulitis is admitted to the hospital for severe abdominal pain and fever. Imaging studies show an ulcerated diverticulum with perforation. This is not coded K63.3 because the etiology is specific, and the perforation has its own ICD-10 code.

Complete medical history including symptoms (abdominal pain, bleeding, changes in bowel habits), physical examination findings,results of diagnostic testing (endoscopy, imaging studies, stool tests), and treatment plan (medications, procedures).Documentation should clearly indicate the location of the ulcer(s) within the intestine.

** Further sub-classification might be possible depending on the etiology or other specific clinical features. Always refer to the most recent ICD-10-CM coding manual for the most updated guidelines and instructions.

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