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2025 ICD-10-CM code K50.013

Crohn's disease affecting the small intestine, complicated by the presence of a fistula.

Adhere to the official ICD-10-CM coding guidelines for accurate code selection. Pay close attention to the specific location of the Crohn's disease and any associated complications when assigning the appropriate code.

Modifiers may be applicable depending on the circumstances and additional procedures performed.

Medical necessity for the diagnosis of K50.013 would be established by the presence of symptoms consistent with Crohn's disease, confirmed by imaging or other diagnostic tests, along with evidence of a fistula (through physical exam, imaging, or other diagnostics).

The clinical responsibility for a patient with K50.013 would involve a gastroenterologist or other physician specializing in inflammatory bowel diseases.The physician's duties encompass diagnosis, treatment planning, monitoring disease progression, and managing complications such as the fistula. This may include medication management, nutritional counseling, and referral for surgical intervention if necessary.

IMPORTANT:Related codes within the K50 family may be applicable depending on the specific location and complications of Crohn's disease. For instance, if the large intestine is also involved, codes from the K50.1 series should be considered.If there's an abscess, K50.014 would be more appropriate.Always refer to the complete clinical picture for accurate code selection.

In simple words: This code means someone has Crohn's disease, a type of bowel inflammation, only in their small intestine.It's made worse by a fistula, which is an abnormal tunnel connecting the intestine to another organ or the skin. This can cause pain and other problems.

K50.013 is an ICD-10-CM code that signifies Crohn's disease specifically localized to the small intestine and further complicated by the formation of a fistula.Crohn's disease is a chronic inflammatory condition that can affect any part of the gastrointestinal tract, but in this instance, it's confined to the small intestine. The presence of a fistula indicates an abnormal connection between the intestine and another organ or the skin surface, resulting from the inflammatory process. This complication can lead to various symptoms, including pain, drainage, infection, and potentially more severe consequences if left untreated.

Example 1: A 35-year-old patient presents with abdominal pain, diarrhea, and weight loss.Imaging studies reveal Crohn's disease affecting the ileum (terminal portion of the small intestine), with a fistula connecting the ileum to the bladder. This would warrant the use of K50.013., A 28-year-old patient with a history of Crohn's disease experiences recurrent episodes of perianal abscesses and drainage.Examination reveals a persistent perianal fistula connected to the small bowel.K50.013 accurately reflects this clinical picture., A 40-year-old patient diagnosed with Crohn's disease of the small intestine undergoes a surgical procedure to repair a fistula that has caused significant complications. K50.013 would be used for the pre-operative diagnosis, with additional procedure codes specifying the surgical intervention.

Complete medical history detailing the symptoms, duration of illness, and any previous treatments. Thorough physical examination, noting the location and extent of the disease.Radiological images (e.g., CT scan, MRI, barium studies) confirming the presence of Crohn's disease and the fistula.Results of any laboratory tests (e.g., complete blood count, inflammatory markers).Documentation of any surgical procedures performed.Documentation of any complications.

** Always review the complete clinical documentation to ensure the most accurate code assignment.Consider any comorbid conditions or other diagnoses that may require additional codes.

  • Revenue Code: Revenue codes will vary depending on the healthcare facility and the specific services rendered.Consult your facility's revenue code guidelines for accurate mapping.
  • RVU: RVUs are not directly associated with ICD-10 codes.RVUs are used for procedural codes (CPT codes) to determine reimbursement.
  • Global Days: Not applicable to ICD-10 codes.
  • Payment Status: Active
  • Modifier TC rule: Not applicable to ICD-10 codes.
  • Fee Schedule: Not applicable to ICD-10 codes. Reimbursement is determined by the payer and other factors.
  • Specialties:Gastroenterology, Surgery
  • Place of Service:Inpatient Hospital, Outpatient Hospital, Office
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