K51.212 — Ulcerative (chronic) proctitis with intestinal obstruction
K51.212 is a billable, specific ICD-10-CM code for ulcerative (chronic) proctitis with intestinal obstruction. It is valid for submission on a claim.
Risk adjustment
K51.212 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.
Medicare coverage
K51.212 is named in 25 Medicare coverage policies — 25 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52423Billing and Coding: Infliximab and biosimilars
- A52423Billing and Coding: Infliximab and biosimilars
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
How K51.212 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K51.212.
- Proctitis›ulcerative›with›complication›obstruction
Related codes at this level
Codes that share K51.21. If K51.212 is not quite right, the correct code is usually one of these.
Questions about K51.212
- Is K51.212 a billable ICD-10-CM code?
- Yes. K51.212 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K51.212 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Noninfective enteritis and colitis (K50-K52).