K92.81 — Gastrointestinal mucositis (ulcerative)
K92.81 is a billable, specific ICD-10-CM code for gastrointestinal mucositis (ulcerative). It is valid for submission on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
Code also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
Risk adjustment
K92.81 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
K92.81 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
- A56394Billing and Coding: Colonoscopy and Sigmoidoscopy-Diagnostic
- A57063Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
- A57414Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
How K92.81 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 K92.81.
- Mucositis›gastrointestinal
Related codes at this level
Codes that share K92.8. If K92.81 is not quite right, the correct code is usually one of these.
Questions about K92.81
- Is K92.81 a billable ICD-10-CM code?
- Yes. K92.81 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K92.81 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).