2024 ICD-10-CM Diagnosis Code K31.6

Approximate Synonyms

The following clinical terms are approximate synonyms or lay terms that might be used to identify the correct diagnosis code:

• Acquired gastric fistula
• Aortic fistula
• Aortointestinal fistula
• Duodenal fistula
• Duodenal stump fistula
• Duodenoaortic fistula
• Duodenocolic fistula
• Duodenoenteric fistula
• Duodenorenal fistula
• Enterocolic fistula
• Enterocutaneous fistula
• Enteroenteric fistula
• Enteroenteric fistula
• Esophagoenteric fistula
• External duodenal fistula
• External gastric fistula
• External gastrointestinal fistula
• External small bowel fistula
• Gastric fistula
• Gastrocolic fistula
• Gastroduodenal disorder
• Gastroduodenal fistula
• Gastrointestinal fistula
• Gastrojejunal fistula
• Gastrojejunocolic fistula
• High-output external gastrointestinal fistula
• Internal duodenal fistula
• Internal gastric fistula
• Internal gastrointestinal fistula
• Jejunal fistula
• Jejunal fistula
• Low-output external gastrointestinal fistula

Clinical Information

• Gastric Fistula-. abnormal passage communicating with the stomach.
• Stomach-. an organ of digestion situated in the left upper quadrant of the abdomen between the termination of the esophagus and the beginning of the duodenum.

Diagnostic Related Groups - MS-DRG Mapping

Diagnostic Related Groups (DRGs) are a classification system used to group together diagnosis codes for the purpose of reimbursement and healthcare management. DRGs are used to standardize the way hospitals and other providers are paid for inpatient services. In this system patients are grouped together based on their principal diagnosis in areas referred to as Major Diagnostic Categories (MDC). Once a patient is assigned a particular diagnostic category, providers receive a predetermined payment rate for the services rendered. This reimbursement rate is often fixed and is meant to cover the cost of care for that patient. Reimbursement is also affected by the relative weight of a diagnostic related group based on the severity of a patient's illness and the associated cost of care during hospitalization.

Diagnostic related groups encourage healthcare providers to focus on quality and efficiency in patient care while managing costs effectively. The diagnosis code is present in the following groups for version MS-DRG V41.0 applicable from 10/01/2023 through 09/30/2024.

MS-DRG	MS-DRG Title	MCD	Relative Weight
391	ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC	06	1.2757
392	ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC	06	0.7856

The relative weight of a diagnostic related group determines the reimbursement rate based on the severity of a patient's illness and the associated cost of care during hospitalization.

Convert to ICD-9-CM Code

Source ICD-10-CM Code		Target ICD-9-CM Code
K31.6		537.4 - Gastric/duodenal fistula

Patient Education

Fistulas

A fistula is an abnormal connection between two parts inside of the body. Fistulas may develop between different organs, such as between the esophagus and the windpipe or the bowel and the vagina. They can also develop between two blood vessels, such as between an artery and a vein or between two arteries.

Some people are born with a fistula. Other common causes of fistulas include:

• Complications from surgery
• Injury
• Infection
• Diseases, such as Crohn's disease or ulcerative colitis

Treatment depends on the cause of the fistula, where it is, and how bad it is. Some fistulas will close on their own. In some cases, you may need antibiotics and/or surgery.

[Learn More in MedlinePlus]

Small Intestine Disorders

Your small intestine is the longest part of your digestive system - about twenty feet long! It connects your stomach to your large intestine (or colon) and folds many times to fit inside your abdomen. Your small intestine does most of the digesting of the foods you eat. It has three areas called the duodenum, the ileum, and the jejunum.

Problems with the small intestine can include:

• Bleeding
• Celiac disease
• Crohn's disease
• Infections
• Intestinal cancer
• Intestinal obstruction
• Irritable bowel syndrome
• Ulcers, such as peptic ulcer

Treatment of disorders of the small intestine depends on the cause.

[Learn More in MedlinePlus]

Stomach Disorders

Your stomach is an organ between your esophagus and small intestine. It is where digestion of protein begins. The stomach has three tasks. It stores swallowed food. It mixes the food with stomach acids. Then it sends the mixture on to the small intestine.

Most people have a problem with their stomach at one time or another. Indigestion and heartburn are common problems. You can relieve some stomach problems with over-the-counter medicines and lifestyle changes, such as avoiding fatty foods or eating more slowly. Other problems like peptic ulcers or GERD require medical attention.

You should see a doctor if you have any of the following:

• Blood when you have a bowel movement
• Severe abdominal pain
• Heartburn not relieved by antacids
• Unintended weight loss
• Ongoing vomiting or diarrhea

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

[Learn More in MedlinePlus]

Code History

• FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
• FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
• FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
• FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
• FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
• FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
• FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
• FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
• FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.