K91.850: Pouchitis
K91.850 is a billable, specific ICD-10-CM code for pouchitis. It is valid for submission on a claim.
Check K91.850 with the rest of the claim: free scrubberInclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Inflammation of internal ileoanal pouch
Excludes2 inherited from the categories above K91.850
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
Risk adjustment
K91.850 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 463 Artificial Openings for Feeding or Elimination0.673 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
K91.850 is named in 6 Medicare coverage policies: 6 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56456Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Alphabetic index entries that lead here
- Pouchitis
- Inflammation, inflamed, inflammatory›ileoanal pouch(internal)
- Inflammation, inflamed, inflammatory›intestinal pouch
Code history
Unchanged in every release from FY2024 to FY2027.