K50.113
K50.113: Crohn's disease of large intestine with fistula
Billable / specific codeICD-10-CM
K50.113 is a billable, specific ICD-10-CM code for crohn's disease of large intestine with fistula. It is valid for submission on a claim.
Check K50.113 with the rest of the claim: free scrubberOther codes that can never be billed with K50.113
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
K50.113 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
K50.113 is named in 31 Medicare coverage policies: 31 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A52423Billing and Coding: Infliximab and biosimilars
- A53057Billing and Coding: Home Health Occupational Therapy
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
Alphabetic index entries that lead here
- Enteritis›regional›large intestine›with›complication›fistula
Code history
Unchanged in every release from FY2024 to FY2027.
Other codes under K50.11
- K50.111Crohn's disease of large intestine with rectal bleeding
- K50.112Crohn's disease of large intestine with intestinal obstruction
- K50.114Crohn's disease of large intestine with abscess
- K50.118Crohn's disease of large intestine with other complication
- K50.119Crohn's disease of large intestine with unspecified complications