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.

Check K64.3 with the rest of the claim: free scrubber

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

A category’s note binds every code beneath it.

Written on K64: Hemorrhoids and perianal venous thrombosis

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

Risk adjustment

No CMS-HCC V28 category: this code does not change a RAF score.

Medicare coverage

K64.3 is named in 3 Medicare coverage policies: 3 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
A57342Billing and Coding: Diagnostic and Therapeutic Colonoscopy

Alphabetic index entries that lead here

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

Code history

Unchanged in every release from FY2024 to FY2027.