K51.012
K51.012: Ulcerative (chronic) pancolitis with intestinal obstruction
Billable / specific codeICD-10-CM
K51.012 is a billable, specific ICD-10-CM code for ulcerative (chronic) pancolitis with intestinal obstruction. It is valid for submission on a claim.
Check K51.012 with the rest of the claim: free scrubberOther codes that can never be billed with K51.012
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
K51.012 risk-adjusts. Under the CMS-HCC V28 model it maps to these categories:
- HCC 78 Intestinal Obstruction/Perforation0.326 RAF
- HCC 81 Ulcerative Colitis0.244 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
K51.012 is named in 25 Medicare coverage policies: 25 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52423Billing and Coding: Infliximab and biosimilars
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
Alphabetic index entries that lead here
- Pancolitis›ulcerative›with›obstruction
Code history
Unchanged in every release from FY2024 to FY2027.