K91.5 — Postcholecystectomy syndrome
K91.5 is a billable, specific ICD-10-CM code for postcholecystectomy syndrome. It is valid for submission on a claim.
Other codes that can never be billed with K91.5
These codes carry an Excludes1 note pointing at K91.5. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K91.5 alone.
Risk adjustment
K91.5 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
K91.5 is named in 4 Medicare coverage policies — 4 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A57414Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
How K91.5 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 K91.5.
- Postcholecystectomy syndrome
- Remnant›cystic duct, postcholecystectomy
- Syndrome›cystic duct stump
- Syndrome›postcholecystectomy
- Complication›surgical procedure›postcholecystectomy syndrome
- Complication›gastrointestinal›postoperative›postcholecystectomy syndrome
Related codes at this level
Codes that share K91. If K91.5 is not quite right, the correct code is usually one of these.
- K91.0Vomiting following gastrointestinal surgery
- K91.1Postgastric surgery syndromes
- K91.2Postsurgical malabsorption, not elsewhere classified
- K91.3Postprocedural intestinal obstruction
- K91.6Intraoperative hemorrhage and hematoma of a digestive system organ or structure complicating a procedure
- K91.7Accidental puncture and laceration of a digestive system organ or structure during a procedure
- K91.8Other intraoperative and postprocedural complications and disorders of digestive system
Questions about K91.5
- Is K91.5 a billable ICD-10-CM code?
- Yes. K91.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K91.5 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).