Stercoral Colitis ICD-10 Code: K56.41

The ICD-10 code for stercoral colitis is K56.41 (Fecal impaction). There is no specific ICD-10-CM code for stercoral colitis itself, so coders must use the fecal impaction code as the primary diagnosis and add codes for any complications.

What Is Stercoral Colitis?

Stercoral colitis is a serious condition where hardened feces (fecalomas) cause pressure necrosis of the colonic wall. It typically occurs in elderly, debilitated, or chronically constipated patients. The condition can progress rapidly to perforation and peritonitis, making accurate coding important for capturing severity.

Primary and Secondary Codes

Since ICD-10-CM lacks a specific stercoral colitis code, you'll typically code multiple conditions:

Sequencing matters: Code the most significant condition first. If the patient presents with peritonitis from stercoral perforation, you might sequence K65.x first with K56.41 as a secondary code explaining the etiology.

Documentation Requirements

For accurate coding, documentation should include:

• Presence of fecal impaction - establishes basis for K56.41
• Colonic wall involvement - ischemia, ulceration, necrosis
• Complications - perforation, peritonitis, sepsis
• Location - sigmoid colon is most common but document specific site
• Imaging or surgical findings - CT findings, operative reports

Common Coding Scenarios

Scenario 1: Stercoral Colitis Without Perforation

Documentation: "CT shows sigmoid wall thickening with fecal impaction. Stercoral colitis. Managed conservatively with disimpaction."

Code: K56.41 (Fecal impaction)

Rationale: Without perforation or other complications, code only the fecal impaction. The colitis is implicit in the fecal impaction diagnosis.

Scenario 2: Stercoral Perforation with Peritonitis

Documentation: "Exploratory laparotomy for stercoral perforation of sigmoid colon with fecal peritonitis. Hartmann procedure performed."

Codes:

• K65.8 (Other peritonitis) or K65.0 if generalized
• K56.41 (Fecal impaction)

Rationale: Sequence the acute life-threatening condition (peritonitis) first. The fecal impaction code explains the cause.

Scenario 3: Stercoral Colitis with Sepsis

Documentation: "Sepsis secondary to stercoral perforation. E. coli grown from blood cultures."

Codes:

• A41.51 (Sepsis due to Escherichia coli)
• K65.1 (Peritoneal abscess) if applicable
• K56.41 (Fecal impaction)

Rationale: Per sepsis coding guidelines, sequence the sepsis code first when sepsis is the reason for admission.

Why There's No Specific Code

ICD-10-CM organizes intestinal conditions by mechanism (obstruction, perforation) rather than specific clinical syndromes. Stercoral colitis is considered a complication of fecal impaction rather than a distinct diagnosis, which is why K56.41 serves as the base code.

This means coders must rely on combination coding to fully capture the clinical picture. Always review operative reports and imaging studies to identify all codeable conditions.