Is K55.3 a billable ICD-10-CM code?

No. K55.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.

Where does K55.3 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 K55.3?

K55.3 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 K55.3 (K55) and apply to it just the same.

K55.3

K55.3 — Necrotizing enterocolitis

Non-billable headerICD-10-CM

K55.3 is a non-billable header ICD-10-CM code for necrotizing enterocolitis. It cannot be billed on its own: choose one of the more specific child codes below.

Excludes1 — never code together

These conditions cannot occur together. Billing both on the same encounter is a denial.

necrotizing enterocolitis of newborn (P77.-)

Excludes2 — not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

necrotizing enterocolitis due to Clostridium difficile (A04.7-)

Excludes1 inherited from the categories above K55.3

These are not written on K55.3, but they bind it: a note on a category applies to every code beneath it. Billing K55.3 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 K55.3

Also inherited, and the opposite of Excludes1: these conditions are not part of K55.3, but a patient can have both, so you may code both.

Written on K55 — Vascular disorders of intestine

angioectasia (angiodysplasia) duodenum (K31.81-)

Risk adjustment

K55.3 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.

Code history

K55.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Code to one of these instead K55.3

4 child codes. Green means billable.

Related codes at this level

Codes that share K55. If K55.3 is not quite right, the correct code is usually one of these.

Questions about K55.3

Is K55.3 a billable ICD-10-CM code?: No. K55.3 is a non-billable header code. Code to a higher level of specificity using one of its child codes.
Where does K55.3 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 K55.3?: K55.3 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 K55.3 (K55) and apply to it just the same.