K51.413 — Inflammatory polyps of colon with fistula
K51.413 is a billable, specific ICD-10-CM code for inflammatory polyps of colon with fistula. It is valid for submission on a claim.
Other codes that can never be billed with K51.413
These codes carry an Excludes1 note pointing at K51.413. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K51.413 alone.
- K63.2Fistula of intestine
Risk adjustment
K51.413 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- 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
K51.413 is named in 24 Medicare coverage policies — 24 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 K51.413 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 K51.413.
- Polyp, polypus›colon›inflammatory›with›fistula
Related codes at this level
Codes that share K51.41. If K51.413 is not quite right, the correct code is usually one of these.
Questions about K51.413
- Is K51.413 a billable ICD-10-CM code?
- Yes. K51.413 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K51.413 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Noninfective enteritis and colitis (K50-K52).