ICD-10 K56.41
Billable / Specific HCC v28: 33Fecal impaction
About ICD-10-CM K56.41
ICD-10-CM code K56.41 represents Fecal impaction. This is a billable/specific code in the Digestive System chapter (block K56). The 2026 edition of ICD-10-CM K56.41 became effective on October 1, 2025.
Coding Tips for K56.41
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K56.41 is a CMS-HCC v28 risk-adjustment code (category 33). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
Type 2 Excludes
Not included here, the excluded code is not part of K56.41, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- incomplete defecation (R15.0)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Medicare LCD Coverage for K56.41
Local Coverage Determinations (LCDs) from CMS MACs that list K56.41 as a covered diagnosis.
Showing top 10 of 35 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K56.41.
2 Medicare
CPT Codes Commonly Billed with K56.41
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 K56.41 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 |
|---|---|---|
| K56.41 | 56032 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K56.41
Other codes in section K55-K64 (Other diseases of intestines).
ICD-10 K56.41, Billing FAQ
Is ICD-10 code K56.41 billable? +
Yes, K56.41 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 2 Excludes for K56.41? +
Type 2 Excludes (may be coded together when both conditions exist): incomplete defecation (R15.0)
Does K56.41 affect Medicare Advantage HCC risk adjustment? +
Yes. K56.41 maps to CMS-HCC v28 category 33. Capture this diagnosis annually for accurate Medicare Advantage risk score.
What ICD-9 codes does K56.41 map to? +
Per CMS GEMs, K56.41 maps to ICD-9 codes: 56032. 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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