K50.813
BillableCrohn's disease of both small and large intestine with fistula
HCC Category Mapping
V28HCC 80 — Crohn's Disease
0.000V24HCC 35 — Inflammatory Bowel Disease
0.289ESRDHCC 35 — Inflammatory Bowel Disease
0.000RxHCCHCC 67 — Inflammatory Bowel Disease
0.000What This Code Means
Crohn's disease affecting both the small and large intestines with an abnormal tunnel-like connection (fistula) between intestinal structures or other organs.
Coding Tips
- •Document the specific type and location of fistula when available for complete clinical picture
- •Fistulas in ileocolonic disease are common and may require surgical intervention
Clinical Significance
Crohn's disease of both small and large intestine with fistula indicates penetrating ileocolonic disease, which is the most common disease phenotype to develop fistulas. Fistulas in ileocolonic Crohn's may be enteroenteric, enterocutaneous, or involve the bladder, vagina, or skin. This complication often requires combination therapy with biologics and surgical intervention.
Documentation Requirements
- ✓Provider documentation of Crohn's disease involving both small and large intestine with fistula
- ✓Confirmation of both anatomic sites being affected
- ✓Type and location of fistula documented
- ✓Diagnostic method confirming fistula (MRI pelvis, CT, fistulogram, examination under anesthesia)
- ✓Treatment plan (biologics, seton placement, surgical intervention)
Commonly Confused Codes
K50.80 — Crohn's disease of both sites without complications: no fistula presentK50.013 — Crohn's disease of small intestine with fistula: small intestine onlyK50.113 — Crohn's disease of large intestine with fistula: large intestine onlyK50.814 — Crohn's disease of both sites with abscess: abscess vs. fistulaK63.2 — Fistula of intestine: not attributed to Crohn's disease
Code Hierarchy
└K50Crohn's disease [regional enteritis]└K50.8Crohn's disease of both small and large intestine└K50.81Crohn's disease of both small and large intestine with complications└K50.813Crohn's disease of both small and large intestine with fistula
└K50.813Crohn's disease of both small and large intestine with fistula