GERD (gastroesophageal reflux disease) ICD-10 code
The ICD-10-CM code for GERD (gastroesophageal reflux disease) is K21.9 (gastro-esophageal reflux disease without esophagitis). It is billable and valid for submission on a claim. There are 14 related codes, and which one you use depends on what the documentation supports.
Also written as acid reflux, reflux, gastroesophageal reflux.
The mistake coders make here
K21.9 is GERD without esophagitis. If esophagitis is documented, you need K21.0-, and whether there is bleeding splits it further (K21.00 vs K21.01).
Putting GERD (gastroesophageal reflux disease) on a claim? Check the claim’s diagnosis codes free: Excludes1 conflicts, header codes and missing seventh characters, before it goes out.
ICD-10-CM codes for GERD (gastroesophageal reflux disease)
9 of 14 are billable. Green means you can submit it as-is.
| Code | Use it when |
|---|---|
| K21.9 | Gastro-esophageal reflux disease without esophagitis |
| K21.00 | Gastro-esophageal reflux disease with esophagitis, without bleeding |
| K21.01 | Gastro-esophageal reflux disease with esophagitis, with bleeding |
| K21 | Gastro-esophageal reflux diseasenot billable on its own |
| K21.0 | Gastro-esophageal reflux disease with esophagitisnot billable on its own |
| P78.83 | Newborn esophageal reflux |
| K22.6 | Gastro-esophageal laceration-hemorrhage syndrome |
| T85.521 | Displacement of esophageal anti-reflux devicenot billable on its own |
| T85.521S | Displacement of esophageal anti-reflux device, sequela |
| T85.511 | Breakdown (mechanical) of esophageal anti-reflux devicenot billable on its own |
| T85.591 | Other mechanical complication of esophageal anti-reflux devicenot billable on its own |
| T85.511S | Breakdown (mechanical) of esophageal anti-reflux device, sequela |
| T85.521A | Displacement of esophageal anti-reflux device, initial encounter |
| T85.521D | Displacement of esophageal anti-reflux device, subsequent encounter |
Once you have the code
- Check the whole claim: Excludes1 conflicts and missing seventh characters, free
- Denial codes explained: what CO-16, CO-97 and the rest actually mean
- Decision guides: walk a chart note to a code, guideline cited
- Everything here that is free, and the one thing no free tool includes
With or without esophagitis, and since FY2021, with or without bleeding
K21.9 is GERD without esophagitis and is the default when the note says only 'GERD' or 'reflux'. K21.0 is GERD with esophagitis, and since 1 October 2020 it must be reported to a fifth character: K21.00 without bleeding, K21.01 with bleeding. The bleeding distinction was added because bleeding esophagitis changes the management and the severity, and a claim still carrying K21.0 is invalid. You do not code K21.9 and K21.0- together: the presence of esophagitis decides which one applies.
Heartburn is a symptom, GERD is a diagnosis
R12 is heartburn, and it is the right code when the provider documents the symptom and has not made the diagnosis. Once GERD is documented, the heartburn is integral to it and is not coded separately. The same logic applies to dyspepsia (R10.13 epigastric pain or K30 functional dyspepsia) and to 'acid reflux' written as a symptom: code what the provider has actually diagnosed, and query when the note oscillates between symptom and disease.
Barrett's, hiatal hernia and esophagitis of other causes
Barrett's esophagus is K22.7- (K22.70 without dysplasia, K22.710 low-grade, K22.711 high-grade, K22.719 dysplasia unspecified) and is coded in addition to the GERD when both are documented: it is a separate condition, not a severity of reflux. A hiatal hernia is K44.- and is also coded separately when documented. Esophagitis that the provider does not attribute to reflux goes to K20.- (K20.0 eosinophilic, K20.8- other, K20.9- unspecified, each now split by bleeding as well), not to K21.0-.
Common questions
- What is the ICD-10 code for GERD without esophagitis?
- K21.9, gastro-esophageal reflux disease without esophagitis. It is billable and is the default for 'GERD' documented with no mention of esophagitis.
- Is K21.0 still a valid code?
- No. Since FY2021 K21.0 requires a fifth character: K21.00 for GERD with esophagitis without bleeding, K21.01 with bleeding. A claim with K21.0 alone is rejected as an invalid code.
- What is the ICD-10 code for heartburn?
- R12, heartburn. Use it only when the provider has documented the symptom without diagnosing GERD. Once GERD is diagnosed, R12 is integral to it and is not reported.