K94.19 — Other complications of enterostomy
K94.19 is a billable, specific ICD-10-CM code for other complications of enterostomy. It is valid for submission on a claim.
Other codes that can never be billed with K94.19
These codes carry an Excludes1 note pointing at K94.19. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading K94.19 alone.
Risk adjustment
K94.19 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
K94.19 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.
- A55937Billing and Coding: Diagnostic Colonoscopy
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56632Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
- A58428Billing and Coding: Diagnostic Colonoscopy
How K94.19 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 K94.19.
- Prolapse, prolapsed›ileostomy bud
- Complication›enterostomy›specified complication NEC
Code history
K94.19 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.
Related codes at this level
Codes that share K94.1. If K94.19 is not quite right, the correct code is usually one of these.
Questions about K94.19
- Is K94.19 a billable ICD-10-CM code?
- Yes. K94.19 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K94.19 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Other diseases of the digestive system (K90-K95).