K91.850

Billable

Pouchitis

HCC Category Mapping

V28HCC 463 — Artificial Openings for Feeding or Elimination

0.233

V24HCC 188 — Artificial Openings for Feeding or Elimination

0.570

ESRDHCC 188 — Artificial Openings for Feeding or Elimination

0.000

What This Code Means

Inflammation of a surgically created pouch in the intestines, typically occurring after bowel surgery.

Coding Tips

•Pouchitis is most common after ileal pouch-anal anastomosis (IPAA) surgery; verify the pouch type in the medical record
•Document symptoms such as diarrhea, abdominal pain, and fever to support the diagnosis

Clinical Significance

Pouchitis represents a significant complication of ileal pouch-anal anastomosis surgery, typically performed for ulcerative colitis or familial adenomatous polyposis. This condition requires specialized management and can significantly impact patient quality of life and functional outcomes.

Documentation Requirements

✓History of ileal pouch-anal anastomosis or similar pouch surgery
✓Clinical symptoms of pouch inflammation
✓Endoscopic evidence of pouch inflammation
✓Exclusion of other causes of symptoms
✓Response to anti-inflammatory therapy
✓Frequency and severity of episodes
✓Impact on pouch function
✓Complications if present

Commonly Confused Codes

K91.858 — Other pouch complications without inflammation K51.90 — Ulcerative colitis may be the underlying condition but not current active disease K63.1 — Perforation of intestine if pouch perforation occurs K92.1 — GI bleeding if pouch bleeding without inflammation

Code Hierarchy

└K91Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classified └K91.8Other intraoperative and postprocedural complications and disorders of digestive system └K91.85Complications of intestinal pouch └K91.850Pouchitis

└K91.850Pouchitis