2027 ICD-10-CM Diagnosis Code K22.3Perforation of esophagus

ICD-10-CM Codes›K00–K95›K20-K31›K22

ICD-10-CM K22.3
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

K22.3 is a billable ICD-10-CM diagnosis code for perforation of esophagus. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 368 through 370, 791, 793. As a secondary diagnosis, it counts as a major complication or comorbidity (MCC) and places an inpatient stay in the highest severity level of its MS-DRG family. It does not count, however, when the principal diagnosis is one of 4 closely related codes. Coders also document this condition as infectious mediastinitis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Esophageal disorders and Gastrointestinal and biliary perforation.

Code Identity

ICD-10-CM Code
K22.3
Billable Status
Yes — Valid for Submission
Code Describes
Perforation of esophagus
Short Description
Perforation of esophagus
Same as the full description in the CMS dataset.
Parent Code
K22
Other diseases of esophagus

Code Classification

ChapterK00–K95Diseases of the digestive system
SectionK20-K31Diseases of esophagus, stomach and duodenum
CategoryK22Other diseases of esophagus
This CodeK22.3Perforation of esophagus

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Infectious mediastinitis
  • Infectious mediastinitis following perforation of esophagus
  • Perforated carcinoma of esophagus
  • Perforation of esophagus
  • Rupture of esophagus
  • Spontaneous rupture of esophagus

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to K22.3: its own notes plus those printed at K22, block K20-K31, and Chapter 11. A note printed at a category, block or chapter applies to every code under it.

Applicable To

Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.

  • Rupture of esophagus

Excludes1

Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.

  • traumatic perforation of (thoracic) esophagus (S27.8-)

Excludes2

Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.

From K22 Other diseases of esophagus applies to 16 codes
  • esophageal varices (I85.-)
From Block K20-K31 Diseases of esophagus, stomach and duodenum applies to 106 codes
From Chapter 11 (K00-K95) Diseases of the digestive system applies to 863 codes
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Source: CMS ICD-10-CM Tabular List. How to read instructional notes.

Referenced in Other NotesGuidance

Instructional notes printed at other codes that name K22.3, its category, or a range that includes it.

Code First 1

These codes say to code first a condition named in the note, and K22.3 is one of the conditions named.

  • J93.12 Secondary spontaneous pneumothorax
    spontaneous rupture of the esophagus (K22.3)

Index to Diseases and InjuriesGuidance

Alphabetical index entries that point to this code.

Clinical ClassificationClinical

AHRQ’s CCSR groups this code into broader clinical categories.

CCSR DIG004
Esophageal disorders
Default principal diagnosis: inpatient No · outpatient No
CCSR DIG006
Gastrointestinal and biliary perforation
Default principal diagnosis: inpatient Yes · outpatient Yes

Clinical InformationClinical

  • Esophageal Perforation

    the presence of a hole or other type of opening in the esophageal wall through which the contents of the esophagus can pass into the mediastinum. the most common cause of esophageal perforation is injury during a medical procedure such as esophagoscopy or placement of a naso-gastric tube; and pathologic process such as neoplasm or gastric reflux with ulceration. less common causes include injuries from penetrating or blunt trauma or injury to the esophagus during an operation on another organ, mechanical problem such as violent retching or vomiting; ingestion of a foreign body or caustic agents. the condition often results in infection of the mediastinum and mediastinitis.

Patient EducationClinical

Esophagus Disorders

Esophagus disorders are problems with how your esophagus works. The esophagus is the tube that carries food from your mouth to your stomach. You usually don't notice it unless you swallow something too big, hot, or cold. You might also notice it if something is wrong.

The full article covers:

  • What are esophagus disorders?
  • What causes esophagus disorders?
  • What are common esophagus disorders?
  • What are symptoms of esophagus disorders?
  • How are esophagus disorders diagnosed?
  • How are esophagus disorders treated?
  • Can esophagus disorders be prevented?

Read the full article at MedlinePlus

Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.

Convert K22.3 to ICD-9-CMHistory

The closest ICD-9-CM equivalents under the General Equivalence Mappings.

ICD-9-CM
530.4 Perforation of esophagus
Exact Match The mapping is direct, with no qualifiers.

Code HistoryHistory

FY 2016AddedAdded to the ICD-10-CM code setEffective October 1, 2015, the first year of ICD-10-CM.
FY 2017–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About K22.3Overview

What is the ICD-10 code for perforation of esophagus?

The ICD-10-CM code for perforation of esophagus is K22.3 (sometimes written as K223). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

Is K22.3 (Other diseases of esophagus) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report perforation of esophagus on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does K22.3 group to?

When perforation of esophagus is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 369, 370, 368, with relative weights from 0.6741 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is K22.3 a CC or MCC?

CMS lists K22.3 as an MCC (major complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it places the inpatient stay in the highest-weighted DRG of its severity family. It does not count when the principal diagnosis is one of the 4 closely related codes in its exclusion list.

Can K22.3 be reported with a code from S27.8?

Not as a rule. The Excludes1 note on K22.3 lists "traumatic perforation of (thoracic) esophagus (S27.8-)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).