Is I85.11 a billable ICD-10-CM code?

Yes. I85.11 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does I85.11 sit in the tabular list?

Diseases of the circulatory system (I00-I99), in the block Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89).

I85.11

I85.11 — Secondary esophageal varices with bleeding

Billable / specific codeICD-10-CM

I85.11 is a billable, specific ICD-10-CM code for secondary esophageal varices with bleeding. It is valid for submission on a claim.

Risk adjustment

I85.11 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 63 Chronic Liver Failure/End-Stage Liver Disorders0.962 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

I85.11 is named in 9 Medicare coverage policies — 9 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
A56531Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin® LAR Depot)
A56704Billing and Coding: Wireless Capsule Endoscopy
A56727Billing and Coding: Wireless Capsule Endoscopy

How I85.11 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 I85.11.

Hemorrhage, hemorrhagic›esophagus›varix›secondary
Varix›esophagus›secondary›bleeding
Varix›esophagus›in›alcoholic liver disease›bleeding
Varix›esophagus›in›cirrhosis of liver›bleeding
Varix›esophagus›in›portal hypertension›bleeding
Varix›esophagus›in›schistosomiasis›bleeding
Varix›esophagus›in›toxic liver disease›bleeding

Related codes at this level

Codes that share I85.1. If I85.11 is not quite right, the correct code is usually one of these.

I85.10Secondary esophageal varices without bleeding

Questions about I85.11

Is I85.11 a billable ICD-10-CM code?: Yes. I85.11 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does I85.11 sit in the tabular list?: Diseases of the circulatory system (I00-I99), in the block Diseases of veins, lymphatic vessels and lymph nodes, not elsewhere classified (I80-I89).