2027 ICD-10-CM Diagnosis Code K51.212Ulcerative (chronic) proctitis with intestinal obstruction
ICD-10-CM Codes›K00–K95›K50-K52›K51
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 78
- Chronic Condition
K51.212 is a billable ICD-10-CM diagnosis code for ulcerative (chronic) proctitis with intestinal obstruction. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 385 through 387. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 77 closely related codes. Coders also document this condition as complication due to chronic ulcerative proctitis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Intestinal obstruction and ileus and Regional enteritis and ulcerative colitis.
For Medicare Advantage risk adjustment, K51.212 maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation) under the V28 model, adding a risk factor of about 0.326 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
K51.212 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Complication due to chronic ulcerative proctitis
- Intestinal obstruction due to chronic ulcerative proctitis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K51.212: its own notes plus those printed at K51, block K50-K52, and Chapter 11. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- noninfective inflammatory bowel disease
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name K51.212, its category, or a range that includes it.
Excludes1 3
These codes carry an Excludes1 note naming K51.212: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 1
These codes carry an Excludes2 note naming K51.212: its condition is not part of those codes, and both may be reported when the patient has both.
Code First 4
These codes say to code first a condition named in the note, and K51.212 is one of the conditions named.
- F54 Psychological and behavioral factors associated with disorders or diseases classified elsewhereulcerative colitis (K51.-) names K51.-, which includes this code
- K60.3 Anal fistulaulcerative colitis (K51.-) names K51.-, which includes this code
- K60.4 Rectal fistulaulcerative colitis (K51.-) names K51.-, which includes this code
- K60.5 Anorectal fistulaulcerative colitis (K51.-) names K51.-, which includes this code
Code Also 2
These codes say K51.212 may also be needed to fully describe the condition. The note gives no sequencing direction.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Colitis, Ulcerative
inflammation of the colon that is predominantly confined to the mucosa. its major symptoms include diarrhea, rectal bleeding, the passage of mucus, and abdominal pain.
Patient EducationClinical
Intestinal Obstruction
An intestinal obstruction occurs when food or stool cannot move through the intestines. The obstruction can be complete or partial. There are many causes. The most common are adhesions, hernias, cancers, and certain medicines.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K51.212 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K51.212Overview
What is the ICD-10 code for ulcerative (chronic) proctitis with intestinal obstruction?
The ICD-10-CM code for ulcerative (chronic) proctitis with intestinal obstruction is K51.212 (sometimes written as K51212). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K51.212 (Ulcerative (chronic) proctitis with complications) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report ulcerative (chronic) proctitis with intestinal obstruction on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K51.212 group to?
When ulcerative (chronic) proctitis with intestinal obstruction is the principal diagnosis on an inpatient stay, it groups to MS-DRG 385, 386, 387, with relative weights from 0.6462 to 1.5540 depending on complications. Higher weights mean higher Medicare reimbursement.
Is K51.212 a CC or MCC?
CMS lists K51.212 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 77 closely related codes in its exclusion list.
Can K51.212 be reported with a code from K50?
Not as a rule. The Excludes1 note at K51, which applies to K51.212, lists "Crohn's disease [regional enteritis] (K50.-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is K51.212?
K51.212 (ulcerative (chronic) proctitis with intestinal obstruction) maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation), commonly written as HCC 78, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 33 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 67.
Does K51.212 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, K51.212 adds a risk adjustment factor of about 0.326 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.326 to 0.688 depending on the payment segment). A more severe related category (HCC 77) supersedes it when both are reported. See the full factor table on the HCC 78 category page.
