K91.858: Other complications of intestinal pouch
K91.858 is a billable, specific ICD-10-CM code for other complications of intestinal pouch. It is valid for submission on a claim.
Check K91.858 with the rest of the claim: free scrubberExcludes2 inherited from the categories above K91.858
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
K91.858 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
K91.858 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
- Complication›intestinal pouch NEC
Code history
Unchanged in every release from FY2024 to FY2027.