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

ICD-10 K21.9

Billable / Specific

Gastro-esophageal reflux disease without esophagitis

K21
Block
1
Synonyms
346
LCDs
21
Payer Policies
6
Linked CPTs

About ICD-10-CM K21.9

ICD-10-CM code K21.9 represents Gastro-esophageal reflux disease without esophagitis. This is a billable/specific code in the Digestive System chapter (block K21). The 2026 edition of ICD-10-CM K21.9 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K21.9. Per CMS ICD-10-CM Tabular 2026.

  • Esophageal reflux NOS

Medicare LCD Coverage for K21.9

Local Coverage Determinations (LCDs) from CMS MACs that list K21.9 as a covered diagnosis.

346 LCDs

Showing top 10 of 346 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74170 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74177 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74160 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74178 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74150 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72194 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 74176 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72192 →
CMS LCD: Billing and Coding: CT of the Abdomen and Pelvis
Article ID: 56421, Effective: 2025-11-01 00:00:00, 5389 covered, 0 non-covered
CPT 72193 →
CMS LCD: Billing and Coding: Endoscopic Treatment of GERD
Article ID: 56395, Effective: 2023-10-01 00:00:00, 3 covered, 1 non-covered
CPT 49999 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K21.9.

21 policies

4 Aetna

Apnea Monitors for Infants - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0003
Gastroesophageal Reflux Disease (GERD)
Policy ID: CPB-0213
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)/Fiberoptic Endoscopic Evaluation of Swallowing with Sensory Testing (FEESST) and Laryngopharyngeal Endoscopic Esthesiometer (LPEER)
Policy ID: CPB-0248
Gastrointestinal Manometry
Policy ID: CPB-0616

5 Medicare

Billing and Coding: Speech-Language Pathology
Policy ID: ART-52866
Billing and Coding: Bariatric Surgery Coverage
Policy ID: ART-53026
Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
Policy ID: ART-56389
Billing and Coding: Endoscopic Treatment of GERD
Policy ID: ART-56395
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421

CPT Codes Commonly Billed with K21.9

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

6 linkages
  • 91035 Esophageal pH monitoring — GERD evaluation, heartburn, retrosternal chest pain, dysphagia, asthma with suspected GERD, chronic cough, Barrett Gastroenterology
  • 43284 CMS LCD: Billing and Coding: Lower Esophageal Magnetic Sphincter Augmentation CMS LCD
  • 43285 CMS LCD: Billing and Coding: Lower Esophageal Magnetic Sphincter Augmentation CMS LCD
  • 43257 CMS LCD: Billing and Coding: Stretta Procedure CMS LCD
  • 43999 CMS LCD: Billing and Coding: Select Minimally Invasive GERD Procedures CMS LCD
  • 49999 CMS LCD: Billing and Coding: Select Minimally Invasive GERD Procedures CMS LCD

Convert K21.9 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
K21.9 53081 00000

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

ICD-10 K21.9, Billing FAQ

Is ICD-10 code K21.9 billable? +

Yes, K21.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to K21.9? +

ICD-10 K21.9 includes: Esophageal reflux NOS.

What CPT codes are commonly billed with K21.9? +

Procedures frequently paired with K21.9 include: 91035, 43284, 43285, 43257, 43999.

What ICD-9 codes does K21.9 map to? +

Per CMS GEMs, K21.9 maps to ICD-9 codes: 53081. 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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