ICD-10 K31.5
Billable / Specific CCObstruction of duodenum
About ICD-10-CM K31.5
ICD-10-CM code K31.5 represents Obstruction of duodenum. This is a billable/specific code in the Digestive System chapter (block K31). The 2026 edition of ICD-10-CM K31.5 became effective on October 1, 2025.
Coding Tips for K31.5
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K31.5 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC 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 K31.5. Per CMS ICD-10-CM Tabular 2026.
- Constriction of duodenum
- Duodenal ileus (chronic)
- Stenosis of duodenum
- Stricture of duodenum
- Volvulus of duodenum
Type 1 Excludes
Pure excludes, these codes can never be coded together with K31.5. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- congenital stenosis of duodenum (Q41.0)
Inpatient DRG Impact, CC
codes Obstruction of duodenum. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for K31.5
Local Coverage Determinations (LCDs) from CMS MACs that list K31.5 as a covered diagnosis.
Showing top 10 of 164 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K31.5.
4 Medicare
1 Aetna
CPT Codes Commonly Billed with K31.5
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
We don't have CPT pairings indexed for this specific code yet. Use the CPT search above to find common procedures, or check your payer's published medical policy for code-specific guidance.
Convert K31.5 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| K31.5 | 5372 | 10000 |
| K31.5 | 5373 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K31.5
Other codes in section K20-K31 (Diseases of esophagus, stomach and duodenum).
ICD-10 K31.5, Billing FAQ
Is ICD-10 code K31.5 billable? +
Yes, K31.5 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 K31.5? +
ICD-10 K31.5 includes: Constriction of duodenum; Duodenal ileus (chronic); Stenosis of duodenum, and 2 more clinical synonyms.
What codes are Type 1 Excludes for K31.5? +
Type 1 Excludes (never code together with K31.5): congenital stenosis of duodenum (Q41.0)
Is K31.5 a CC or MCC for inpatient DRG? +
Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What ICD-9 codes does K31.5 map to? +
Per CMS GEMs, K31.5 maps to ICD-9 codes: 5372, 5373. 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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