Is K55.1 a billable ICD-10-CM code?

Yes. K55.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does K55.1 sit in the tabular list?

Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).

What cannot be coded together with K55.1?

K55.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above K55.1 (K55) and apply to it just the same.

K55.1

K55.1 — Chronic vascular disorders of intestine

Billable / specific codeICD-10-CM

K55.1 is a billable, specific ICD-10-CM code for chronic vascular disorders of intestine. It is valid for submission on a claim.

Inclusion terms

Alternative wordings a physician may use in the chart for this same code.

Chronic ischemic colitis
Chronic ischemic enteritis
Chronic ischemic enterocolitis
Ischemic stricture of intestine
Mesenteric atherosclerosis
Mesenteric vascular insufficiency

Excludes1 inherited from the categories above K55.1

These are not written on K55.1, but they bind it: a note on a category applies to every code beneath it. Billing K55.1 with anything listed here is a denial.

Written on K55 — Vascular disorders of intestine

necrotizing enterocolitis of newborn (P77.-)

Excludes2 inherited from the categories above K55.1

Also inherited, and the opposite of Excludes1: these conditions are not part of K55.1, but a patient can have both, so you may code both.

Written on K55 — Vascular disorders of intestine

angioectasia (angiodysplasia) duodenum (K31.81-)

Other codes that can never be billed with K55.1

These codes carry an Excludes1 note pointing at K55.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K55.1 alone.

K56Paralytic ileus and intestinal obstruction without hernia

Risk adjustment

K55.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.

Medicare coverage

K55.1 is named in 28 Medicare coverage policies — 28 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A55937Billing and Coding: Diagnostic Colonoscopy
A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56421Billing and Coding: CT of the Abdomen and Pelvis

How K55.1 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 K55.1.

Wilkie's disease or syndrome
Abdomen, abdominal›angina
Angina›abdominal
Angina›intestinal
Angina›mesenteric
Arteriosclerosis, arteriosclerotic›mesenteric(artery)
Disease, diseased›Wilkie's
Insufficiency, insufficient›mesenteric
Ischemia, ischemic›colon chronic(due to mesenteric artery insufficiency)
Syndrome›Wilkie's
Colitis›ischemic›chronic
Colitis›ischemic›due to mesenteric artery insufficiency

Code history

K55.1 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share K55. If K55.1 is not quite right, the correct code is usually one of these.

Questions about K55.1

Is K55.1 a billable ICD-10-CM code?: Yes. K55.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K55.1 sit in the tabular list?: Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).
What cannot be coded together with K55.1?: K55.1 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above K55.1 (K55) and apply to it just the same.