K50.913
K50.913: Crohn's disease, unspecified, with fistula
Billable / specific codeICD-10-CM
K50.913 is a billable, specific ICD-10-CM code for crohn's disease, unspecified, with fistula. It is valid for submission on a claim.
Check K50.913 with the rest of the claim: free scrubberOther codes that can never be billed with K50.913
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
K50.913 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
K50.913 is named in 27 Medicare coverage policies: 27 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›with›complication›fistula
Code history
Unchanged in every release from FY2024 to FY2027.