ICD-10 K75.1
Billable / Specific MCCPhlebitis of portal vein
About ICD-10-CM K75.1
ICD-10-CM code K75.1 represents Phlebitis of portal vein. This is a billable/specific code in the Digestive System chapter (block K75). The 2026 edition of ICD-10-CM K75.1 became effective on October 1, 2025.
Coding Tips for K75.1
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K75.1 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.
Inclusion Terms / Approximate Synonyms
Clinical terms and conditions classified under K75.1. Per CMS ICD-10-CM Tabular 2026.
- Pylephlebitis
Type 1 Excludes
Pure excludes, these codes can never be coded together with K75.1. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- pylephlebitic liver abscess (K75.0)
Inpatient DRG Impact, MCC
codes Phlebitis of portal vein. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for K75.1
Local Coverage Determinations (LCDs) from CMS MACs that list K75.1 as a covered diagnosis.
Showing top 10 of 109 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K75.1.
2 Aetna
5 Medicare
CPT Codes Commonly Billed with K75.1
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 K75.1 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 |
|---|---|---|
| K75.1 | 5721 | 10000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K75.1
Other codes in section K70-K77 (Diseases of liver).
ICD-10 K75.1, Billing FAQ
Is ICD-10 code K75.1 billable? +
Yes, K75.1 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 K75.1? +
ICD-10 K75.1 includes: Pylephlebitis.
What codes are Type 1 Excludes for K75.1? +
Type 1 Excludes (never code together with K75.1): pylephlebitic liver abscess (K75.0)
Is K75.1 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 ICD-9 codes does K75.1 map to? +
Per CMS GEMs, K75.1 maps to ICD-9 codes: 5721. 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 June 1, 2026.
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