ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 K20.9

Non-Billable Header

Esophagitis, unspecified

K20
Block
0
Synonyms
0
LCDs
1
Payer Policies
1
Linked CPTs

About ICD-10-CM K20.9

ICD-10-CM code K20.9 represents Esophagitis, unspecified. This is a non-billable header code in the Digestive System chapter (block K20). The 2026 edition of ICD-10-CM K20.9 became effective on October 1, 2025. Non-billable codes cannot be used as a primary or secondary diagnosis on a claim, use a more specific child code instead.

Medicare LCD Coverage for K20.9

Local Coverage Determinations (LCDs) from CMS MACs that list K20.9 as a covered diagnosis.

No Medicare LCDs reference K20.9 as covered

This doesn't mean the code isn't covered, it means no MAC has issued a Local Coverage Determination naming this specific code. Coverage may still apply under National Coverage Determinations or general medical-necessity rules.

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K20.9.

1 policies

1 Cigna

Nucleic Acid Pathogen Testing - (0530)
Policy ID: MM_0530

CPT Codes Commonly Billed with K20.9

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 43235 Diagnostic EGD — abdominal pain, nausea, vomiting, GERD, gastric ulcer, gastritis, hematemesis, melena, Barrett esophagus, dysphagia, esophagitis, weight loss, iron deficiency anemia, polyp Gastroenterology

Convert K20.9 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
K20.9 53010 10000
K20.9 53012 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 K20.9, Billing FAQ

Is ICD-10 code K20.9 billable? +

No, K20.9 is a non-billable header code. Use a more specific child code from block K20 when submitting claims.

What CPT codes are commonly billed with K20.9? +

Procedures frequently paired with K20.9 include: 43235.

What ICD-9 codes does K20.9 map to? +

Per CMS GEMs, K20.9 maps to ICD-9 codes: 53010, 53012. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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