K51.813
BillableOther ulcerative colitis with fistula
HCC Category Mapping
V28HCC 81 — Ulcerative Colitis
0.000V24HCC 35 — Inflammatory Bowel Disease
0.289ESRDHCC 35 — Inflammatory Bowel Disease
0.000RxHCCHCC 67 — Inflammatory Bowel Disease
0.000What This Code Means
A form of ulcerative colitis affecting areas of the colon other than the left side, with an abnormal tunnel-like opening (fistula).
Coding Tips
- •Confirm documentation specifies fistula formation in association with the ulcerative colitis
- •Note fistula location if documented, as this provides additional clinical context
Clinical Significance
Other ulcerative colitis with fistula indicates fistula formation in a form of ulcerative colitis with an atypical anatomic distribution. The presence of fistula is unusual in ulcerative colitis and should prompt careful diagnostic reassessment to differentiate from Crohn disease, which more commonly presents with fistulizing complications.
Documentation Requirements
- ✓Confirmed ulcerative colitis with documented extent
- ✓Fistula type and location documented
- ✓Imaging confirmation of fistula
- ✓Provider statement attributing fistula to the colitis
- ✓Documentation of diagnostic reconsideration for Crohn disease
- ✓Surgical consultation and treatment plan
Commonly Confused Codes
Code Hierarchy
└K51Ulcerative colitis└K51.8Other ulcerative colitis└K51.81Other ulcerative colitis with complications└K51.813Other ulcerative colitis with fistula
└K51.813Other ulcerative colitis with fistula