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

ICD-10 K80.46

Billable / Specific CC

Calculus of bile duct with acute and chronic cholecystitis without obstruction

K80
Block
0
Synonyms
94
LCDs
3
Payer Policies
0
Linked CPTs

About ICD-10-CM K80.46

ICD-10-CM code K80.46 represents Calculus of bile duct with acute and chronic cholecystitis without obstruction. This is a billable/specific code in the Digestive System chapter (block K80). The 2026 edition of ICD-10-CM K80.46 became effective on October 1, 2025.

Coding Tips for K80.46

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

K80.46 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.

Inpatient DRG Impact, CC

codes Calculus of bile duct with acute and chronic cholecystitis without obstruction. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for K80.46

Local Coverage Determinations (LCDs) from CMS MACs that list K80.46 as a covered diagnosis.

94 LCDs

Showing top 10 of 94 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: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Article ID: 57063, Effective: 2025-10-01 00:00:00, 820 covered, 1 non-covered
CPT 43246 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing K80.46.

3 policies

3 Medicare

Billing and Coding: CT of the Abdomen and Pelvis
Policy ID: ART-56421
Billing and Coding: Diagnostic and Therapeutic Esophagogastroduodenoscopy
Policy ID: ART-57063
Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
Policy ID: ART-57414

CPT Codes Commonly Billed with K80.46

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

No procedure linkages on file for K80.46

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 K80.46 to ICD-9-CM

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

ICD-10ICD-9Mapping Flags
K80.46 57430 10111
K80.46 57440 10112

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

Codes Adjacent To K80.46

Other codes in section K80-K87 (Disorders of gallbladder, biliary tract and pancreas).

ICD-10 K80.46, Billing FAQ

Is ICD-10 code K80.46 billable? +

Yes, K80.46 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

Is K80.46 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 ICD-9 codes does K80.46 map to? +

Per CMS GEMs, K80.46 maps to ICD-9 codes: 57430, 57440. 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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