K31.6

K31.6: Fistula of stomach and duodenum

Billable / specific codeICD-10-CM

K31.6 is a billable, specific ICD-10-CM code for fistula of stomach and duodenum. It is valid for submission on a claim.

Check K31.6 with the rest of the claim: free scrubber

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

, if applicable, disruption of internal operation (surgical) wound (T81.32-)

Inclusion terms

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

Gastrocolic fistula
Gastrojejunocolic fistula

Excludes2 inherited from the categories above K31.6

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 K31.6

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

K63.2Fistula of intestine

Risk adjustment

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

Medicare coverage

K31.6 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

Fistula›duodenum
Fistula›gastric
Fistula›gastrocolic
Fistula›gastroenterocolic
Fistula›gastroesophageal
Fistula›gastrojejunal
Fistula›gastrojejunocolic
Fistula›stomach

Code history

Unchanged in every release from FY2024 to FY2027.