K31.1

K31.1: Adult hypertrophic pyloric stenosis

Billable / specific codeICD-10-CM

K31.1 is a billable, specific ICD-10-CM code for adult hypertrophic pyloric stenosis. It is valid for submission on a claim.

Check K31.1 with the rest of the claim: free scrubber

Excludes1: never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

congenital pyloric stenosis (Q40.0)

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Acquired hypertrophic pyloric stenosis
Adult pyloric stenosis
Pyloric stenosis NOS

Excludes2 inherited from the categories above K31.1

Not part of this code, but both may be coded when both are present.

Written on K31: Other diseases of stomach and duodenum

diabetic gastroparesis (E08.43, E09.43, E10.43, E11.43, E13.43)
diverticulum of duodenum (K57.00-K57.13)

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

K31.1 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
A56421Billing and Coding: CT of the Abdomen and Pelvis
A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
A57414Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)

Alphabetic index entries that lead here

Constriction›pylorus(adult hypertrophic)
Hypertrophy, hypertrophic›pylorus(adult) (muscle) (sphincter)
Obstruction, obstructed, obstructive›gastric outlet
Occlusion, occluded›pylorus, adult
Stenosis, stenotic›pylorus(hypertrophic) (acquired)
Stricture›pylorus(hypertrophic)
Obstruction, obstructed, obstructive›pylorus›adult
Stenosis, stenotic›pylorus›adult
Stricture›pylorus›adult

Code history

Unchanged in every release from FY2024 to FY2027.