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

ICD-10 K31.811

Billable / Specific MCC

Angiodysplasia of stomach and duodenum with bleeding

K31
Block
0
Synonyms
175
LCDs
6
Payer Policies
1
Linked CPTs

About ICD-10-CM K31.811

ICD-10-CM code K31.811 represents Angiodysplasia of stomach and duodenum with bleeding. This is a billable/specific code in the Digestive System chapter (block K31). The 2026 edition of ICD-10-CM K31.811 became effective on October 1, 2025.

Coding Tips for K31.811

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

Inpatient DRG impact: MCC

K31.811 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.

Inpatient DRG Impact, MCC

codes Angiodysplasia of stomach and duodenum with bleeding. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.

Medicare LCD Coverage for K31.811

Local Coverage Determinations (LCDs) from CMS MACs that list K31.811 as a covered diagnosis.

175 LCDs

Showing top 10 of 175 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: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43246 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K31.811.

6 policies

5 Medicare

Billing and Coding: Bevacizumab and biosimilars
Policy ID: ART-52370
Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
Policy ID: ART-56389
Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Policy ID: ART-57063
Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Policy ID: ART-57414

CPT Codes Commonly Billed with K31.811

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

1 linkages
  • 43249 EGD with dilation — Barrett esophagus, esophageal stricture, esophageal web, gastric outlet obstruction, esophageal polyp, gastric polyp Gastroenterology

Convert K31.811 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
K31.811 53783 00000

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

ICD-10 K31.811, Billing FAQ

Is ICD-10 code K31.811 billable? +

Yes, K31.811 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is K31.811 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 K31.811? +

Procedures frequently paired with K31.811 include: 43249.

What ICD-9 codes does K31.811 map to? +

Per CMS GEMs, K31.811 maps to ICD-9 codes: 53783. 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 July 16, 2026.

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