K94.12 — Enterostomy infection
K94.12 is a billable, specific ICD-10-CM code for enterostomy infection. It is valid for submission on a claim.
Risk adjustment
K94.12 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
K94.12 is named in 3 Medicare coverage policies — 3 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
- A58428Billing and Coding: Diagnostic Colonoscopy
How K94.12 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 K94.12.
- Abscess›enterostomy
- Abscess›ileostomy(bud)
- Infection, infected, infective›enterostomy
- Complication›enterostomy›infection
Related codes at this level
Codes that share K94.1. If K94.12 is not quite right, the correct code is usually one of these.
Questions about K94.12
- Is K94.12 a billable ICD-10-CM code?
- Yes. K94.12 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K94.12 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).