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.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Obstruction of intestine by gallstone
Other codes that can never be billed with K56.3
These codes carry an Excludes1 note pointing at K56.3. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K56.3 alone.
- K56.0Paralytic ileus
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.
Medicare coverage
K56.3 is named in 10 Medicare coverage policies — 10 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How K56.3 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 K56.3.
- 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
Related codes at this level
Codes that share K56. If K56.3 is not quite right, the correct code is usually one of these.
Questions about K56.3
- Is K56.3 a billable ICD-10-CM code?
- Yes. K56.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K56.3 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).