K94.11

K94.11: Enterostomy hemorrhage

Billable / specific codeICD-10-CM

K94.11 is a billable, specific ICD-10-CM code for enterostomy hemorrhage. It is valid for submission on a claim.

Check K94.11 with the rest of the claim: free scrubber

Other codes that can never be billed with K94.11

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

Z43Encounter for attention to artificial openings
Z93Artificial opening status

Risk adjustment

K94.11 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

K94.11 is named in 5 Medicare coverage policies: 5 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›enterostomy›hemorrhage

Code history

Unchanged in every release from FY2024 to FY2027.