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K51.913

Billable

Ulcerative colitis, unspecified with fistula

HCC Category Mapping

V28HCC 81Ulcerative Colitis
0.000
V24HCC 35Inflammatory Bowel Disease
0.289
ESRDHCC 35Inflammatory Bowel Disease
0.000
RxHCCHCC 67Inflammatory Bowel Disease
0.000

What This Code Means

Ulcerative colitis of unspecified extent with an abnormal tunnel-like connection between the colon and other tissues.

Coding Tips

  • Document the location and type of fistula (enterocutaneous, rectovaginal, etc.) for complete clinical documentation.
  • Fistulas in ulcerative colitis may require additional codes if they involve other organs or require separate treatment.

Clinical Significance

Ulcerative colitis, unspecified, with fistula indicates fistula formation in ulcerative colitis of undetermined extent. The presence of a fistula is unusual for ulcerative colitis and should prompt both determination of disease extent and reconsideration of whether the diagnosis might be Crohn disease, which is far more commonly associated with fistulizing disease.

Documentation Requirements

  • Confirmed ulcerative colitis diagnosis
  • Documentation of fistula type and location
  • Imaging confirmation of fistula
  • Provider statement linking fistula to the colitis
  • Documentation of diagnostic reconsideration for Crohn disease
  • Surgical consultation and treatment plan

Commonly Confused Codes

Code Hierarchy

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