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

ICD-10 K38.9

Billable / Specific

Disease of appendix, unspecified

K38
Block
0
Synonyms
60
LCDs
2
Payer Policies
0
Linked CPTs

About ICD-10-CM K38.9

ICD-10-CM code K38.9 represents Disease of appendix, unspecified. This is a billable/specific code in the Digestive System chapter (block K38). The 2026 edition of ICD-10-CM K38.9 became effective on October 1, 2025.

Medicare LCD Coverage for K38.9

Local Coverage Determinations (LCDs) from CMS MACs that list K38.9 as a covered diagnosis.

60 LCDs

Showing top 10 of 60 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: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Article ID: 56632, Effective: 2025-10-01 00:00:00, 558 covered, 0 non-covered
CPT 45341 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K38.9.

2 policies

2 Medicare

Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy
Policy ID: ART-56632

CPT Codes Commonly Billed with K38.9

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

No procedure linkages on file for K38.9

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 K38.9 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
K38.9 5439 10000

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

Codes Adjacent To K38.9

Other codes in section K35-K38 (Diseases of appendix).

K35 Acute appendicitis (non-billable) K35.2 Acute appendicitis with generalized peritonitis (non-billable) K35.20 Acute appendicitis with generalized peritonitis, without abscess (non-billable) K35.200 Acute appendicitis with generalized peritonitis, without perforation or abscess K35.201 Acute appendicitis with generalized peritonitis, with perforation, without abscess K35.209 Acute appendicitis with generalized peritonitis, without abscess, unspecified as to perforation K35.21 Acute appendicitis with generalized peritonitis, with abscess (non-billable) K35.210 Acute appendicitis with generalized peritonitis, without perforation, with abscess K35.211 Acute appendicitis with generalized peritonitis, with perforation and abscess K35.219 Acute appendicitis with generalized peritonitis, with abscess, unspecified as to perforation K35.3 Acute appendicitis with localized peritonitis (non-billable) K35.30 Acute appendicitis with localized peritonitis, without perforation or gangrene K35.31 Acute appendicitis with localized peritonitis and gangrene, without perforation K35.32 Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess K35.33 Acute appendicitis with perforation, localized peritonitis, and gangrene, with abscess K35.8 Other and unspecified acute appendicitis (non-billable) K35.80 Unspecified acute appendicitis K35.89 Other acute appendicitis (non-billable) K35.890 Other acute appendicitis without perforation or gangrene K35.891 Other acute appendicitis without perforation, with gangrene

ICD-10 K38.9, Billing FAQ

Is ICD-10 code K38.9 billable? +

Yes, K38.9 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What ICD-9 codes does K38.9 map to? +

Per CMS GEMs, K38.9 maps to ICD-9 codes: 5439. 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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