K50.013

K50.013: Crohn's disease of small intestine with fistula

Billable / specific codeICD-10-CM

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.

Check K50.013 with the rest of the claim: free scrubber

Excludes1 inherited from the categories above K50.013

A category’s note binds every code beneath it.

Written on K50.0: Crohn's disease of small intestine

Crohn's disease of both small and large intestine (K50.8-)

Written on K50: Crohn's disease [regional enteritis]

ulcerative colitis (K51.-)

Other codes that can never be billed with K50.013

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

E55.0Rickets, active
K51Ulcerative colitis
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. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

K50.013 is named in 29 Medicare coverage policies: 29 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A52423Billing and Coding: Infliximab and biosimilars
A55937Billing and Coding: Diagnostic Colonoscopy
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56416Billing and Coding: Assays for Vitamins and Metabolic Function

Alphabetic index entries that lead here

Enteritis›regional›small intestine›with›complication›fistula

Code history

Unchanged in every release from FY2024 to FY2027.