K64.1 — Second degree hemorrhoids
K64.1 is a billable, specific ICD-10-CM code for second degree hemorrhoids. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Grade/stage II hemorrhoids
- Hemorrhoids (bleeding) that prolapse with straining, but retract spontaneously
Risk adjustment
K64.1 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
K64.1 is named in 3 Medicare coverage policies — 3 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A57342Billing and Coding: Diagnostic and Therapeutic Colonoscopy
How K64.1 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 K64.1.
- Hemorrhoids›2nd degree(grade/stage II) (that prolapse with straining but retract spontaneously)
Related codes at this level
Codes that share K64. If K64.1 is not quite right, the correct code is usually one of these.
Questions about K64.1
- Is K64.1 a billable ICD-10-CM code?
- Yes. K64.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K64.1 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of intestines (K55-K64).