2025 ICD-10-CM code K51.813
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Gastrointestinal Diseases - Other ulcerative colitis with complications Diseases of the digestive system Feed
Other ulcerative colitis with fistula.
Modifiers may be applicable depending on the specific circumstances of the encounter, such as the type of service rendered or the location of the encounter.
Medical necessity for this code is established by the presence of active ulcerative colitis complicated by a fistula. The fistula may cause significant symptoms, such as pain, infection, and/or abscess formation, thus necessitating medical intervention.
The clinical responsibility for this diagnosis code falls upon gastroenterologists or colorectal surgeons.They would be responsible for the diagnosis, treatment planning, surgical interventions (if required), and ongoing management of the ulcerative colitis and the fistula.
In simple words: This code describes a type of inflammatory bowel disease called ulcerative colitis, which causes inflammation and sores in the large intestine.This specific code means the condition is complicated by an abnormal connection (fistula) from the intestine to another part of the body.
This code is for other ulcerative colitis that is complicated by the presence of a fistula.Ulcerative colitis is a chronic inflammatory condition affecting the colon and rectum. A fistula is an abnormal connection between two organs or vessels, in this case, likely an abnormal connection from the colon or rectum to another structure.The term "other" implies that the condition doesn't precisely fit into more specific ulcerative colitis categories.
Example 1: A 45-year-old female patient with a history of ulcerative colitis presents with recurrent abdominal pain, fever, and a palpable mass.Imaging studies reveal a perianal fistula extending from the rectum.The patient is diagnosed with K51.813., A 60-year-old male patient with long-standing ulcerative colitis experiences worsening symptoms, including abdominal pain, weight loss, and fatigue.A colonoscopy and imaging studies reveal a fistula between the sigmoid colon and the bladder. K51.813 is assigned., A 30-year-old patient with a known diagnosis of ulcerative colitis undergoes surgery for a complicated perirectal abscess that extends into a fistula. Following surgical debridement and fistula repair, code K51.813 is assigned.
Detailed history of ulcerative colitis, including onset, duration, and severity of symptoms.Complete physical examination noting the presence of a fistula (location, size, characteristics). Imaging studies (e.g., CT scan, MRI, fistulogram) to confirm the diagnosis and extent of the fistula.Results of any laboratory tests relevant to inflammatory bowel disease. Surgical or other treatment records, if applicable.
** Further specificity regarding the location and type of fistula may be documented in free text.
- Payment Status: Active
- Specialties:Gastroenterology, Colorectal Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office