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

ICD-10 K22.3

Billable / Specific MCC

Perforation of esophagus

K22
Block
1
Synonyms
164
LCDs
5
Payer Policies
1
Linked CPTs

About ICD-10-CM K22.3

ICD-10-CM code K22.3 represents Perforation of esophagus. This is a billable/specific code in the Digestive System chapter (block K22). The 2026 edition of ICD-10-CM K22.3 became effective on October 1, 2025.

Coding Tips for K22.3

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: MCC

K22.3 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under K22.3. Per CMS ICD-10-CM Tabular 2026.

  • Rupture of esophagus

Type 1 Excludes

Pure excludes, these codes can never be coded together with K22.3. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • traumatic perforation of (thoracic) esophagus (S27.8-)

Inpatient DRG Impact, MCC

codes Perforation of esophagus. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for K22.3

Local Coverage Determinations (LCDs) from CMS MACs that list K22.3 as a covered diagnosis.

164 LCDs

Showing top 10 of 164 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43246 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43243 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43235 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43250 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43236 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43247 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43249 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43254 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43245 →
CMS LCD: Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43244 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K22.3.

5 policies

5 Medicare

Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
Policy ID: ART-56389
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Policy ID: ART-57063
Billing and Coding: Electrocardiograms
Policy ID: ART-57326
Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Policy ID: ART-57414

CPT Codes Commonly Billed with K22.3

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

1 linkages
  • 43753 Gastrostomy tube placement Gastroenterology

Convert K22.3 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
K22.3 5304 00000

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

ICD-10 K22.3, Billing FAQ

Is ICD-10 code K22.3 billable? +

Yes, K22.3 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 K22.3? +

ICD-10 K22.3 includes: Rupture of esophagus.

What codes are Type 1 Excludes for K22.3? +

Type 1 Excludes (never code together with K22.3): traumatic perforation of (thoracic) esophagus (S27.8-)

Is K22.3 a CC or MCC for inpatient DRG? +

Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with K22.3? +

Procedures frequently paired with K22.3 include: 43753.

What ICD-9 codes does K22.3 map to? +

Per CMS GEMs, K22.3 maps to ICD-9 codes: 5304. 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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