ICD-10 K92.0
Billable / Specific CCHematemesis
About ICD-10-CM K92.0
ICD-10-CM code K92.0 represents Hematemesis. This is a billable/specific code in the Digestive System chapter (block K92). The 2026 edition of ICD-10-CM K92.0 became effective on October 1, 2025.
Coding Tips for K92.0
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K92.0 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 Hematemesis. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.
Medicare LCD Coverage for K92.0
Local Coverage Determinations (LCDs) from CMS MACs that list K92.0 as a covered diagnosis.
Showing top 10 of 174 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K92.0.
5 Medicare
1 Aetna
CPT Codes Commonly Billed with K92.0
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- 43235 Diagnostic EGD — abdominal pain, nausea, vomiting, GERD, gastric ulcer, gastritis, hematemesis, melena, Barrett esophagus, dysphagia, esophagitis, weight loss, iron deficiency anemia, polyp Gastroenterology
- 43249 EGD with dilation — Barrett esophagus, esophageal stricture, esophageal web, gastric outlet obstruction, esophageal polyp, gastric polyp Gastroenterology
- 85027 CBC automated — anemia, iron deficiency, fatigue, routine exam, abnormal labs, melena, hematemesis Laboratory
- 99283 ED visit level 3 — chest pain, dyspnea, pneumonia, UTI, forearm fracture, tibia fracture, syncope, GI bleed Emergency Medicine
- 99284 ED visit level 4 — MI, PE, COPD exacerbation, asthma exacerbation, syncope, GI bleed, hip fracture, concussion, altered consciousness, DKA Emergency Medicine
Convert K92.0 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 |
|---|---|---|
| K92.0 | 5780 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K92.0
Other codes in section K90-K95 (Other diseases of the digestive system).
ICD-10 K92.0, Billing FAQ
Is ICD-10 code K92.0 billable? +
Yes, K92.0 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
Is K92.0 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 K92.0? +
Procedures frequently paired with K92.0 include: 43235, 43249, 85027, 99283, 99284.
What ICD-9 codes does K92.0 map to? +
Per CMS GEMs, K92.0 maps to ICD-9 codes: 5780. 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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