K38.9 — Disease of appendix, unspecified
K38.9 is a billable, specific ICD-10-CM code for disease of appendix, unspecified. It is valid for submission on a claim.
Risk adjustment
K38.9 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
K38.9 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
How K38.9 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 K38.9.
- Disease, diseased›appendix
Related codes at this level
Codes that share K38. If K38.9 is not quite right, the correct code is usually one of these.
Questions about K38.9
- Is K38.9 a billable ICD-10-CM code?
- Yes. K38.9 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K38.9 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of appendix (K35-K38).