General Surgery Coding Alert

Question: I’m having trouble with the level of detail for Crohn’s reporting now that we no longer use ICD-9. For instance, how should I code Crohn’s identified in the large intestine with an abscess using ICD-10?

Tennessee Subscriber

Answer: The correct code is K50.114 (add descriptor). Let’s walk through how you would choose that code.

First, you must identify the location of the Crohn’s using one of the following choices:

• K50.0_ — Crohn’s disease of small intestine
• K50.1_ — … of large intestine
• K50.8_ — … of both small and large intestine
• K50.9_ — … unspecified.

You would select K50.1_, but then you’d need to select a fifth digit as follows:

• 0 — without complications
• 1 — with complications.

That’s not all: Because in your case the fifth digit is 1, you must add a sixth digit from the following list to avoid a truncated code:

• 1 — with rectal bleeding
• 2 — with intestinal obstruction
• 3 — with fistula
• 4 — with abscess
• 8 — with other complication
• 9 — with unspecified complications.

Once you go through those steps, you should settle on K50.114 for the condition you describe.