Is K63.2 a billable ICD-10-CM code?

Yes. K63.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does K63.2 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 K63.2?

K63.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.

K63.2

K63.2 — Fistula of intestine

Billable / specific codeICD-10-CM

K63.2 is a billable, specific ICD-10-CM code for fistula of intestine. It is valid for submission on a claim.

Excludes1 — never code together

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

fistula of duodenum (K31.6)
fistula of intestine with Crohn's disease (K50.013, K50.113, K50.813, K50.913,)
fistula of intestine with ulcerative colitis (K51.013, K51.213, K51.313, K51.413, K51.513, K51.813, K51.913)

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.

fistula of anal and rectal regions (K60.-)
fistula of appendix (K38.3)
intestinal-genital fistula, female (N82.2-N82.4)
vesicointestinal fistula (N32.1)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

, if applicable, disruption of internal operation (surgical) wound (T81.32-)

Risk adjustment

K63.2 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

K63.2 is named in 9 Medicare coverage policies — 9 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
A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56432Billing and Coding: Infliximab

How K63.2 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 K63.2.

Fistula›abdomen(wall)
Fistula›abdominorectal
Fistula›abdominosigmoidal
Fistula›cecosigmoidal
Fistula›cecum
Fistula›colon
Fistula›enterocolic
Fistula›enterocutaneous
Fistula›fecal
Fistula›ileorectal or ileosigmoidal
Fistula›ileum
Fistula›intestine NEC

Related codes at this level

Codes that share K63. If K63.2 is not quite right, the correct code is usually one of these.

Questions about K63.2

Is K63.2 a billable ICD-10-CM code?: Yes. K63.2 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K63.2 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 K63.2?: K63.2 carries an Excludes1 note, which means the conditions it lists can never be coded together with it on the same encounter.