2025 ICD-10-CM code K50.913
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Gastrointestinal Diseases - Noninfective enteritis and colitis Diseases of the digestive system Feed
Crohn's disease, unspecified, with fistula.
Modifiers may apply depending on the circumstances of care. Consult the current CPT and HCPCS modifier guidelines for details.
Medical necessity for coding K50.913 is established by clinical documentation supporting the diagnosis of Crohn's disease and the presence of a fistula.The documentation should clearly demonstrate the need for diagnostic and/or therapeutic interventions related to the Crohn's disease and the fistula.
The clinical responsibility for coding K50.913 rests with the physician or qualified healthcare professional who diagnoses and manages the patient's Crohn's disease and associated fistula.This includes performing appropriate examinations, ordering and interpreting diagnostic tests (e.g., endoscopy, imaging studies), and determining the appropriate treatment plan.
In simple words: This code is for Crohn's disease, a type of inflammatory bowel disease, where there's an abnormal connection (a fistula) between parts of the intestine or between the intestine and the skin.
This ICD-10-CM code classifies Crohn's disease, a chronic inflammatory bowel disease, of unspecified location, with the presence of a fistula.A fistula is an abnormal connection between two organs or between an organ and the body surface. In the context of Crohn's disease, fistulas often connect the bowel to the skin or to another part of the bowel.
Example 1: A 35-year-old female patient presents with recurrent abdominal pain, diarrhea, and weight loss.Colonoscopy reveals transmural inflammation consistent with Crohn's disease, and a fistula is identified connecting the ileum to the skin near the perineum.K50.913 is assigned., A 48-year-old male patient with a history of Crohn's disease experiences a new onset of perianal symptoms, including drainage and pain.A physical examination and imaging studies confirm a perianal fistula.K50.913 is used to code the diagnosis., A 28-year-old patient with a known diagnosis of Crohn's disease of the ileum is admitted to the hospital due to an intestinal obstruction and a newly discovered enterocutaneous fistula.Surgical intervention is required to resolve the obstruction and address the fistula.K50.913 is coded, along with codes for the intestinal obstruction and any surgical procedures performed.Additional codes may be required to reflect the location of the Crohn's disease.
Complete medical history, including symptoms (e.g., abdominal pain, diarrhea, weight loss, perianal symptoms), prior medical diagnoses (e.g., IBD), diagnostic test results (e.g., colonoscopy report, imaging studies such as CT or MRI), and findings that confirm both Crohn's disease and the fistula.The location of the fistula should be documented precisely. Surgical reports, if applicable.
** Always ensure proper documentation to support the diagnosis of both Crohn's disease and the presence of the fistula.Additional codes might be necessary to specify the location of the Crohn's disease and the type and location of the fistula.When considering surgical procedures, ensure that appropriate procedure codes are included along with this diagnosis code. Consult with your coding resources and the latest updates to national coding guidelines for comprehensive accuracy.
- Payment Status: Active
- Modifier TC rule: Not applicable to this ICD-10-CM code.
- Specialties:Gastroenterology, Surgery, Internal Medicine
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Ambulatory Surgical Center