K31.5

K31.5: Obstruction of duodenum

Billable / specific codeICD-10-CM

K31.5 is a billable, specific ICD-10-CM code for obstruction of duodenum. It is valid for submission on a claim.

Check K31.5 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 stenosis of duodenum (Q41.0)

Inclusion terms

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

Constriction of duodenum
Duodenal ileus (chronic)
Stenosis of duodenum
Stricture of duodenum
Volvulus of duodenum

Excludes2 inherited from the categories above K31.5

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)

Other codes that can never be billed with K31.5

Their own Excludes1 notes name this code, so the conflict is not listed above.

K56Paralytic ileus and intestinal obstruction without hernia

Risk adjustment

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

Medicare coverage

K31.5 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

Cicatrix›duodenum, obstructive(bulb)
Constriction›duodenum
Ileus›duodenal(chronic)
Obstruction, obstructed, obstructive›duodenum
Scar, scarring›duodenum, obstructive
Stasis›duodenal
Stenosis, stenotic›duodenum
Stricture›duodenum
Syndrome›aortomesenteric duodenum occlusion
Volvulus›duodenum

Code history

Unchanged in every release from FY2024 to FY2027.