ICD-10 K68.11
Billable / Specific CCPostprocedural retroperitoneal abscess
About ICD-10-CM K68.11
ICD-10-CM code K68.11 represents Postprocedural retroperitoneal abscess. This is a billable/specific code in the Digestive System chapter (block K68). The 2026 edition of ICD-10-CM K68.11 became effective on October 1, 2025.
Coding Tips for K68.11
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K68.11 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.
Type 2 Excludes
Not included here, the excluded code is not part of K68.11, but a patient may have both conditions at the same time. Both codes may be coded together when applicable.
- infection following procedure (T81.4-)
Inpatient DRG Impact, CC
1068:53 codes Postprocedural retroperitoneal abscess. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for K68.11
Local Coverage Determinations (LCDs) from CMS MACs that list K68.11 as a covered diagnosis.
Showing top 10 of 266 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K68.11.
5 Medicare
CPT Codes Commonly Billed with K68.11
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 10081 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
- 10180 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
- 10080 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
- 10160 CMS LCD: Billing and Coding: Incision and Drainage (I&D) of Abscess of Skin, Subcutaneous and Accessory Structures CMS LCD
Convert K68.11 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 |
|---|---|---|
| K68.11 | 99859 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K68.11
Other codes in section K65-K68 (Diseases of peritoneum and retroperitoneum).
ICD-10 K68.11, Billing FAQ
Is ICD-10 code K68.11 billable? +
Yes, K68.11 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 K68.11? +
Type 2 Excludes (may be coded together when both conditions exist): infection following procedure (T81.4-)
Is K68.11 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 K68.11? +
Procedures frequently paired with K68.11 include: 10081, 10180, 10080, 10160.
What ICD-9 codes does K68.11 map to? +
Per CMS GEMs, K68.11 maps to ICD-9 codes: 99859. Useful for legacy data review and historical claim analysis.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on July 17, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team