K50.813 — Crohn's disease of both small and large intestine with fistula
K50.813 is a billable, specific ICD-10-CM code for crohn's disease of both small and large intestine with fistula. It is valid for submission on a claim.
Other codes that can never be billed with K50.813
These codes carry an Excludes1 note pointing at K50.813. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K50.813 alone.
- K63.2Fistula of intestine
Risk adjustment
K50.813 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
K50.813 is named in 33 Medicare coverage policies — 33 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
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
How K50.813 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 K50.813.
- Enteritis›regional›large intestine›with›complication›small intestine involvement›with›complication›fistula
- Enteritis›regional›small intestine›with›complication›large intestine involvement›with›complication›fistula
Related codes at this level
Codes that share K50.81. If K50.813 is not quite right, the correct code is usually one of these.
- K50.811Crohn's disease of both small and large intestine with rectal bleeding
- K50.812Crohn's disease of both small and large intestine with intestinal obstruction
- K50.814Crohn's disease of both small and large intestine with abscess
- K50.818Crohn's disease of both small and large intestine with other complication
- K50.819Crohn's disease of both small and large intestine with unspecified complications
Questions about K50.813
- Is K50.813 a billable ICD-10-CM code?
- Yes. K50.813 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K50.813 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Noninfective enteritis and colitis (K50-K52).