Is K64.3 a billable ICD-10-CM code?

Yes. K64.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does K64.3 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 K64.3?

K64.3 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 K64.3 (K64) and apply to it just the same.

K64.3

K64.3 — Fourth degree hemorrhoids

Billable / specific codeICD-10-CM

K64.3 is a billable, specific ICD-10-CM code for fourth 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 IV hemorrhoids
Hemorrhoids (bleeding) with prolapsed tissue that cannot be manually replaced

Excludes1 inherited from the categories above K64.3

These are not written on K64.3, but they bind it: a note on a category applies to every code beneath it. Billing K64.3 with anything listed here is a denial.

Written on K64 — Hemorrhoids and perianal venous thrombosis

hemorrhoids complicating childbirth and the puerperium (O87.2)
hemorrhoids complicating pregnancy (O22.4)

Risk adjustment

K64.3 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.

Medicare coverage

K64.3 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 K64.3 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 K64.3.

Hemorrhoids›4th degree(grade/stage IV) (with prolapsed tissue that cannot be manually replaced)

Code history

K64.3 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share K64. If K64.3 is not quite right, the correct code is usually one of these.

Questions about K64.3

Is K64.3 a billable ICD-10-CM code?: Yes. K64.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does K64.3 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 K64.3?: K64.3 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 K64.3 (K64) and apply to it just the same.