ICD-10 Coding Tip: Crohn’s Disease

ICD-10 Coding Tip: Crohn’s Disease

Crohn’s disease is a chronic inflammation of the gastrointestinal tract that most frequently affects the end of the small bowel and the beginning of the large bowel. Potential symptoms include persistent diarrhea, cramping, abdominal pain, fever, rectal bleeding, fatigue, loss of appetite, and weight loss. The disease is not limited to the gastrointestinal tract, and may affect the joints, eyes, skin, and liver. Crohn’s disease can occur at any age, but usually occurs between the ages of 15-35.
The location of the Crohn’s disease, as well as any complication or manifestation, are important to code selection, as follows:
K50.00 Crohn’s disease of small intestine without complication
K50.011 Crohn’s disease of small intestine with rectal bleeding
K50.012 Crohn’s disease of small intestine with intestinal obstruction
K50.013 Crohn’s disease of small intestine with fistula
K50.014 Crohn’s disease of small intestine with abscess
K50.018 Crohn’s disease of small intestine with other complication
K50.019 Crohn’s disease of small intestine unspecified complications
K50.10 Crohn’s disease of large intestine without complications
K50.111 Crohn’s disease of large intestine with rectal bleeding
K50.112 Crohn’s disease of large intestine with intestinal obstruction
K50.113 Crohn’s disease of large intestine with fistula
K50.114 Crohn’s disease of large intestine with abscess
K50.118 Crohn’s disease of large intestine with other complication
K50.119 Crohn’s disease of large intestine unspecified complications
K50.80 Crohn’s disease of both small and large intestine without complications
K50.811 Crohn’s disease of both small and large intestine with rectal bleeding
K50.812 Crohn’s disease of both small and large intestine with intestinal obstruction
K50.813 Crohn’s disease of both small and large intestine with fistula
K50.814 Crohn’s disease of both small and large intestine with abscess
K50.818 Crohn’s disease of both small and large intestine with other complication
K50.819 Crohn’s disease of both small and large intestine unspecified complications
K50.90 Crohn’s disease, unspecified without complication
K50.911 Crohn’s disease, unspecified with rectal bleeding
K50.912 Crohn’s disease, unspecified with intestinal obstruction
K50.913 Crohn’s disease, unspecified with fistula
K50.914 Crohn’s disease, unspecified with abscess
K50.918 Crohn’s disease, unspecified with other complication
K50.919 Crohn’s disease, unspecified with unspecified complications
Example: A 30-year-old male presents with multiple, non-bloody, loose stools per day, right lower quadrant abdominal pain that occurs especially after eating, and 25 lb. weight loss. Physical examination show a definite and moderately tender 5 cm mass in the right lower quadrant of his abdomen. Results of the stool studies are negative for enteric pathogens. Results from his blood work show mild anemia with normal metabolic panel and normal thyroid-stimulating hormone levels. Radiographic findings demonstrate a 10 cm narrowing in the terminal ileum, with a separation of bowel loops around the terminal ileum. The diagnosis is Crohn’s disease.
Based on the documentation, the correct ICD-10-CM code is K50.00 Crohn’s disease of the small intestine without complications.

John Verhovshek
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John Verhovshek, MA, CPC, is a contributing editor at AAPC. He has been covering medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University.

No Responses to “ICD-10 Coding Tip: Crohn’s Disease”

  1. Deb Walters says:

    Thank you, this was good info.

  2. Mary says:

    Why wouldn’t it be K50.90? The example doesn’t specify that it is the small intestine.

  3. Jana Marschke says:

    Terminal ileum-K50.00

  4. Lauriann Deangelo says:

    Doesn’t the weight loss and abdominal pain justify using the K50. 018- WITH complications?