K91.5

K91.5: Postcholecystectomy syndrome

Billable / specific codeICD-10-CM

K91.5 is a billable, specific ICD-10-CM code for postcholecystectomy syndrome. It is valid for submission on a claim.

Check K91.5 with the rest of the claim: free scrubber

Excludes2 inherited from the categories above K91.5

Not part of this code, but both may be coded when both are present.

Written on K91: Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classified

complications of artificial opening of digestive system (K94.-)
complications of bariatric procedures (K95.-)
gastrojejunal ulcer (K28.-)
postprocedural (radiation) retroperitoneal abscess (K68.11)
radiation colitis (K52.0)
radiation gastroenteritis (K52.0)
radiation proctitis (K62.7)

Other codes that can never be billed with K91.5

Their own Excludes1 notes name this code, so the conflict is not listed above.

K82Other diseases of gallbladder
K83Other diseases of biliary tract

Risk adjustment

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

Medicare coverage

K91.5 is named in 4 Medicare coverage policies: 4 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

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)

Alphabetic index entries that lead here

Postcholecystectomy syndrome
Remnant›cystic duct, postcholecystectomy
Syndrome›cystic duct stump
Syndrome›postcholecystectomy
Complication›surgical procedure›postcholecystectomy syndrome
Complication›gastrointestinal›postoperative›postcholecystectomy syndrome

Code history

Unchanged in every release from FY2024 to FY2027.