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.
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.
Medicare coverage
K91.858 is named in 6 Medicare coverage policies — 6 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How K91.858 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 K91.858.
- Complication›intestinal pouch NEC
Related codes at this level
Codes that share K91.85. If K91.858 is not quite right, the correct code is usually one of these.
Questions about K91.858
- Is K91.858 a billable ICD-10-CM code?
- Yes. K91.858 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K91.858 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).