2025 ICD-10-CM code K51.4
(Active) Effective Date: N/A Revision Date: N/A Gastrointestinal Diseases - Ulcerative colitis Diseases of the digestive system Feed
Inflammatory polyps of the colon.
Modifiers may apply based on the circumstances of the procedure.Consult appropriate resources for modifier guidance.
Medical necessity for coding K51.4 is established by the presence of symptoms suggestive of inflammatory bowel disease or colitis, and confirmed by diagnostic imaging and/or endoscopic procedures showing the characteristic features of inflammatory polyps.
The clinical responsibility for coding K51.4 falls upon the physician or qualified healthcare provider who diagnoses and manages the patient's condition. This requires a thorough review of the patient's history, physical examination, laboratory results, and imaging studies (if performed). The documentation must clearly support the diagnosis.
In simple words: This code describes non-cancerous, inflamed growths (polyps) in the large intestine (colon). These polyps are often associated with inflammatory bowel disease or other types of colitis.
K51.4, Inflammatory polyps of the colon, refers to non-neoplastic polypoid lesions within the colon.These lesions are characterized by distorted epithelium, inflammation, and fibrosis. They can occur in the context of inflammatory bowel disease or colitis.This code excludes adenomatous polyps of the colon (D12.6), polyposis of the colon (D12.6), and polyps of the colon not otherwise specified (K63.5).
Example 1: A 55-year-old female patient presents with rectal bleeding and abdominal pain. Colonoscopy reveals multiple inflammatory polyps in the sigmoid colon.The patient is diagnosed with K51.41 (inflammatory polyps of the colon with complications – rectal bleeding)., A 40-year-old male patient with a history of ulcerative colitis undergoes a colonoscopy which shows numerous inflammatory polyps throughout the colon.No acute complications are noted. The appropriate code is K51.40 (inflammatory polyps of the colon without complications)., A 60-year-old patient with a history of Crohn's disease undergoes surgery for bowel obstruction caused by inflammatory polyps.The appropriate code would be K51.41 (inflammatory polyps of the colon with complications – intestinal obstruction), along with codes specifying the surgical procedure.
Comprehensive medical records are essential. Documentation should include the patient's history, physical examination findings, results of colonoscopy or other imaging studies that reveal the presence of inflammatory polyps, and any associated complications.The report should clearly differentiate inflammatory polyps from other types of polyps.
** Always cross-reference with other relevant codes, such as codes for inflammatory bowel disease or specific complications if present.Pay close attention to the distinction between inflammatory polyps and other types of colonic polyps.
- Payment Status: Active
- Modifier TC rule: Not applicable to this diagnostic code.
- Specialties:Gastroenterology, Colorectal Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center