K56.3: Gallstone ileus
K56.3 is a billable, specific ICD-10-CM code for gallstone ileus. It is valid for submission on a claim.
Check K56.3 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Obstruction of intestine by gallstone
Excludes1 inherited from the categories above K56.3
A category’s note binds every code beneath it.
Written on K56: Paralytic ileus and intestinal obstruction without hernia
Excludes2 inherited from the categories above K56.3
Not part of this code, but both may be coded when both are present.
Other codes that can never be billed with K56.3
Their own Excludes1 notes name this code, so the conflict is not listed above.
Risk adjustment
K56.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 78 Intestinal Obstruction/Perforation0.326 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
K56.3 is named in 10 Medicare coverage policies: 10 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55336Billing and Coding: Retroperitoneal Ultrasound
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Alphabetic index entries that lead here
- Gallstone›causing intestinal obstruction
- Ileus›due to gallstone(in intestine)
- Ileus›gallstone
- Impaction, impacted›bowel, colon, rectum›by gallstone
- Impaction, impacted›gallstone›in intestine, with obstruction(any part)
- Impaction, impacted›intestine NEC›gallstone, with ileus
- Obstruction, obstructed, obstructive›intestine›by gallstone
Code history
Unchanged in every release from FY2024 to FY2027.