ICD-10 K52.1
Billable / Specific CCToxic gastroenteritis and colitis
About ICD-10-CM K52.1
ICD-10-CM code K52.1 represents Toxic gastroenteritis and colitis. This is a billable/specific code in the Digestive System chapter (block K52). The 2026 edition of ICD-10-CM K52.1 became effective on October 1, 2025.
Coding Tips for K52.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K52.1 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 K52.1. Per CMS ICD-10-CM Tabular 2026.
- Drug-induced gastroenteritis and colitis
Use Additional Code
When coding K52.1, 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
- (T51-T65) to identify toxic agent
Inpatient DRG Impact, CC
code Toxic gastroenteritis and colitis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for K52.1
Local Coverage Determinations (LCDs) from CMS MACs that list K52.1 as a covered diagnosis.
Showing top 10 of 844 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K52.1.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with K52.1
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- J2353 CMS LCD: Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin� LAR Depot) CMS LCD
Convert K52.1 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 |
|---|---|---|
| K52.1 | 5582 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K52.1
Other codes in section K50-K52 (Noninfective enteritis and colitis).
ICD-10 K52.1, Billing FAQ
Is ICD-10 code K52.1 billable? +
Yes, K52.1 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 K52.1? +
ICD-10 K52.1 includes: Drug-induced gastroenteritis and colitis.
Is K52.1 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 CPT codes are commonly billed with K52.1? +
Procedures frequently paired with K52.1 include: J2353.
What ICD-9 codes does K52.1 map to? +
Per CMS GEMs, K52.1 maps to ICD-9 codes: 5582. 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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