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

ICD-10 K22.1

Non-Billable Header

Ulcer of esophagus

K22
Block
7
Synonyms
0
LCDs
0
Payer Policies
1
Linked CPTs

About ICD-10-CM K22.1

ICD-10-CM code K22.1 represents Ulcer of esophagus. This is a non-billable header code in the Digestive System chapter (block K22). The 2026 edition of ICD-10-CM K22.1 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.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K22.1. Per CMS ICD-10-CM Tabular 2026.

  • Barrett's ulcer
  • Erosion of esophagus
  • Fungal ulcer of esophagus
  • Peptic ulcer of esophagus
  • Ulcer of esophagus due to ingestion of chemicals
  • Ulcer of esophagus due to ingestion of drugs and medicaments
  • Ulcerative esophagitis

Type 1 Excludes

Pure excludes, these codes can never be coded together with K22.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • Barrett's esophagus (K22.7-)

Use Additional Code

When coding K22.1, also report these additional codes when applicable.

  • code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Coding Notes

Code First

  • poisoning due to drug or toxin, if applicable (T36-T65 with fifth or sixth character 1-4)

Medicare LCD Coverage for K22.1

Local Coverage Determinations (LCDs) from CMS MACs that list K22.1 as a covered diagnosis.

No Medicare LCDs reference K22.1 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 K22.1.

No commercial payer policies reference K22.1 on file

Our payer policy database covers Aetna, Cigna, Anthem, BCBS, Humana, and Medicare Advantage plans, but K22.1 doesn't currently appear in any indexed policy. The code may still be covered under standard plan benefits.

CPT Codes Commonly Billed with K22.1

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

1 linkages
  • 43753 Gastrostomy tube placement Gastroenterology

ICD-10 K22.1, Billing FAQ

Is ICD-10 code K22.1 billable? +

No, K22.1 is a non-billable header code. Use a more specific child code from block K22 when submitting claims.

What other names or terms map to K22.1? +

ICD-10 K22.1 includes: Barrett's ulcer; Erosion of esophagus; Fungal ulcer of esophagus, and 4 more clinical synonyms.

What codes are Type 1 Excludes for K22.1? +

Type 1 Excludes (never code together with K22.1): Barrett's esophagus (K22.7-)

What CPT codes are commonly billed with K22.1? +

Procedures frequently paired with K22.1 include: 43753.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on June 1, 2026.

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