K50.013 — Crohn's disease of small intestine with fistula
K50.013 is a billable, specific ICD-10-CM code for crohn's disease of small intestine with fistula. It is valid for submission on a claim.
Other codes that can never be billed with K50.013
These codes carry an Excludes1 note pointing at K50.013. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K50.013 alone.
- K63.2Fistula of intestine
Risk adjustment
K50.013 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 80 Crohn's Disease (Regional Enteritis)0.550 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
K50.013 is named in 31 Medicare coverage policies — 31 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A52423Billing and Coding: Infliximab and biosimilars
- A52423Billing and Coding: Infliximab and biosimilars
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
How K50.013 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 K50.013.
- Enteritis›regional›small intestine›with›complication›fistula
Related codes at this level
Codes that share K50.01. If K50.013 is not quite right, the correct code is usually one of these.
- K50.011Crohn's disease of small intestine with rectal bleeding
- K50.012Crohn's disease of small intestine with intestinal obstruction
- K50.014Crohn's disease of small intestine with abscess
- K50.018Crohn's disease of small intestine with other complication
- K50.019Crohn's disease of small intestine with unspecified complications
Questions about K50.013
- Is K50.013 a billable ICD-10-CM code?
- Yes. K50.013 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K50.013 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Noninfective enteritis and colitis (K50-K52).