Complications of artificial openings of the digestive system
In Other diseases of the digestive system (K90-K95), chapter 11: Diseases of the Digestive System
20 billable codes under K94: 15 are a CC; all map to HCC 463 (Artificial Openings for Feeding or Elimination).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
There are no chapter-specific rules for Chapter 11 yet, so the general rules in Section I.B apply.
All codes under K94
K94 can't be used on a claim. Pick a billable code below; grey headings group them.
- K94.0Colostomy complications
- K94.00Colostomy complication, unspecified
- K94.01Colostomy hemorrhage
- K94.02Colostomy infection
- K94.03Colostomy malfunction
- K94.09Other complications of colostomy
- K94.1Enterostomy complications
- K94.10Enterostomy complication, unspecified
- K94.11Enterostomy hemorrhage
- K94.12Enterostomy infection
- K94.13Enterostomy malfunction
- K94.19Other complications of enterostomy
- K94.2Gastrostomy complications
- K94.20Gastrostomy complication, unspecified
- K94.21Gastrostomy hemorrhage
- K94.22Gastrostomy infection
- K94.23Gastrostomy malfunction
- K94.29Other complications of gastrostomy
- K94.3Esophagostomy complications
- K94.30Esophagostomy complications, unspecified
- K94.31Esophagostomy hemorrhage
- K94.32Esophagostomy infection
- K94.33Esophagostomy malfunction
- K94.39Other complications of esophagostomy
K94 MS-DRGs
As the principal diagnosis, all 20 billable codes under K94 group to MS-DRG 393, 394, or 395 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
Other codes that refer to K94
Notes on these codes point to K94.
- K91 Excludes2: complications of artificial opening of digestive system (K94.-)
- T80-T88 Excludes2: ostomy complications (J95.0-, K94.-, N99.5-)
- T81 Excludes2: ostomy complications (J95.0-, K94.-, N99.5-)
- Z43 Excludes1: complications of external stoma (J95.0-, K94.-, N99.5-)
- Z93 Excludes1: complications of external stoma (J95.0-, K94.-, N99.5-)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Ostomy
An ostomy is surgery to create an opening (stoma) from an area inside the body to the outside. It treats certain diseases of the digestive or urinary systems. It can be permanent, when an organ must be removed. It can be temporary, when the organ needs time to heal. The organ could be the small intestine, colon, rectum, or bladder. With an ostomy, there must be a new way for wastes to leave the body.
Read more about ostomy on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.