2027 ICD-10-CM Diagnosis Code K56.609Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction

ICD-10-CM Codes›K00–K95›K55-K64›K56

ICD-10-CM K56.609
CMSSource: CMS FY 2027 ICD-10-CM dataset · Effective Oct 1, 2026 – Sep 30, 2027

K56.609 is a billable ICD-10-CM diagnosis code for unspecified intestinal obstruction, unspecified as to partial versus complete obstruction. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 388 through 390, 791, 793. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 29 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Intestinal obstruction and ileus.

For Medicare Advantage risk adjustment, K56.609 maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation) under the V28 model, adding a risk factor of about 0.326 for a community, non-dual, aged beneficiary in payment year 2027.

Code Identity

ICD-10-CM Code
K56.609
Billable Status
Yes — Valid for Submission
Code Describes
Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction
Short Description
Unsp intestnl obst, unsp as to partial versus complete obst
Parent Code
K56.60
Unspecified intestinal obstruction

Code Classification

ChapterK00–K95Diseases of the digestive system
SectionK55-K64Other diseases of intestines
CategoryK56Paralytic ileus and intestinal obstruction without hernia
This CodeK56.609Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction

Medicare Risk Adjustment (HCC)Billing

K56.609 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.

CMS-HCC V28 Category (Payment Model)
HCC 78— Intestinal Obstruction/Perforation
Payment HCC · PY 2027 one of 76 ICD-10-CM codes in this category
Risk Adjustment Factor (RAF) Weight
+0.326
community, non-dual, aged · ranges 0.326–0.688 across segments
Hierarchy
Superseded by HCC 77
a more severe related category takes the payment when both are reported
Prior Model (CMS-HCC V24)
HCC 33
V24 retired V28 pays 100% of MA risk scores since PY 2026
Other CMS Models
PACE (CMS-HCC V22): HCC 33 · ESRD (V21): HCC 33 · ESRD (V24): HCC 33
ESRD V21 weights: 0.072 dialysis, 0.285–0.346 functioning graft · ESRD V24 weights: 0.078 dialysis, 0.250–0.474 functioning graft
Part D (RxHCC)
Not mapped
K56.609 does not risk-adjust in the RxHCC prescription drug model

Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.

Approximate SynonymsGuidance

Alternate terms and clinical phrases that map to this code.

  • Acute gastric ulcer with hemorrhage
  • Acute gastric ulcer with hemorrhage and obstruction
  • Acute gastric ulcer with hemorrhage and perforation
  • Acute gastric ulcer with hemorrhage, with perforation and with obstruction
  • Acute gastric ulcer with obstruction
  • Acute gastric ulcer with perforation
  • Acute gastric ulcer with perforation AND obstruction
  • Acute gastrojejunal ulcer with hemorrhage
  • Acute gastrojejunal ulcer with hemorrhage and obstruction
  • Acute gastrojejunal ulcer with hemorrhage and perforation
  • Acute gastrojejunal ulcer with hemorrhage, with perforation and with obstruction
  • Acute gastrojejunal ulcer with obstruction
  • Acute gastrojejunal ulcer with perforation
  • Acute gastrojejunal ulcer with perforation AND obstruction
  • Acute gastrojejunal ulcer without hemorrhage AND without perforation
  • Acute gastrojejunal ulcer without hemorrhage AND without perforation but with obstruction
  • Acute intestinal obstruction
  • Acute peptic ulcer with hemorrhage AND obstruction
  • Acute peptic ulcer with hemorrhage and perforation
  • Acute peptic ulcer with hemorrhage, with perforation AND with obstruction
  • Acute peptic ulcer with perforation AND obstruction
  • Acute peptic ulcer without hemorrhage AND without perforation
  • Acute peptic ulcer without hemorrhage AND without perforation but with obstruction
  • Chronic gastrojejunal ulcer with hemorrhage
  • Chronic gastrojejunal ulcer with hemorrhage and obstruction
  • Chronic gastrojejunal ulcer with hemorrhage and perforation
  • Chronic gastrojejunal ulcer with hemorrhage, with perforation and with obstruction
  • Chronic gastrojejunal ulcer with obstruction
  • Chronic gastrojejunal ulcer with perforation
  • Chronic gastrojejunal ulcer with perforation AND with obstruction
  • Chronic peptic ulcer with hemorrhage AND obstruction
  • Chronic peptic ulcer with hemorrhage AND perforation
  • Chronic peptic ulcer with hemorrhage, with perforation AND with obstruction
  • Chronic peptic ulcer with perforation AND obstruction
  • Crohn's disease of small intestine with stenosis
  • Diaphragmatic hernia with gangrene
  • Extrinsic intestinal obstruction
  • Gastric anastomotic hemorrhage
  • Gastric necrosis
  • Gastric ulcer with hemorrhage and obstruction
  • Gastric ulcer with hemorrhage and perforation
  • Gastric ulcer with hemorrhage, with perforation and with obstruction
  • Gastric ulcer with perforation AND obstruction
  • Gastric ulcer without hemorrhage AND without perforation but with obstruction
  • Gastrointestinal obstruction
  • Gastrojejunal ulcer with hemorrhage AND obstruction
  • Gastrojejunal ulcer with hemorrhage AND perforation
  • Gastrojejunal ulcer with hemorrhage, with perforation and with obstruction
  • Gastrojejunal ulcer with perforation AND obstruction
  • Gastrojejunal ulcer without hemorrhage AND without perforation
  • Gastrojejunal ulcer without hemorrhage AND without perforation but with obstruction
  • Hiatal hernia with gangrene AND obstruction
  • Hiatus hernia with gangrene
  • Hiatus hernia with obstruction
  • Intestinal obstruction
  • Large bowel obstruction
  • Obstructed diaphragmatic hernia
  • Obstructed diaphragmatic hernia with gangrene
  • Obstruction of colon
  • Peptic ulcer with hemorrhage AND obstruction
  • Peptic ulcer with hemorrhage, with perforation AND with obstruction
  • Peptic ulcer with obstruction
  • Peptic ulcer without hemorrhage AND without perforation but with obstruction
  • Small bowel obstruction
  • Stenosis of intestine
  • Stricture of intestine
  • Stricture of small intestine

Instructional NotesGuidance

Instructions from the official ICD-10-CM Tabular List that apply to K56.609: its own notes plus those printed at K56 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.

  • Intestinal obstruction NOS

Excludes1

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

From K56 Paralytic ileus and intestinal obstruction without hernia applies to 16 codes
  • congenital stricture or stenosis of intestine (Q41-Q42)
  • cystic fibrosis with meconium ileus (E84.11)
  • ischemic stricture of intestine (K55.1)
  • meconium ileus NOS (P76.0)
  • neonatal intestinal obstructions classifiable to P76.-
  • obstruction of duodenum (K31.5)
  • postprocedural intestinal obstruction (K91.3-)

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 K56 Paralytic ileus and intestinal obstruction without hernia applies to 16 codes
  • stenosis of anus or rectum (K62.4)
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 K56.609, its category, or a range that includes it.

Excludes1 1

These codes carry an Excludes1 note naming K56.609: they are not reported together with it, unless the two conditions are unrelated.

  • P76.8 Other specified intestinal obstruction of newborn
    intestinal obstruction classifiable to K56.- names K56.-, which includes this code

Excludes2 1

These codes carry an Excludes2 note naming K56.609: its condition is not part of those codes, and both may be reported when the patient has both.

  • Block R10-R19 Symptoms and signs involving the digestive system and abdomen
    intestinal obstruction (K56.-) names K56.-, which includes this code

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 DIG012
Intestinal obstruction and ileus
Default principal diagnosis: inpatient Yes · outpatient Yes

Patient EducationClinical

Intestinal Obstruction

An intestinal obstruction occurs when food or stool cannot move through the intestines. The obstruction can be complete or partial. There are many causes. The most common are adhesions, hernias, cancers, and certain medicines.

Read the full article at MedlinePlus

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

Convert K56.609 to ICD-9-CMHistory

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

ICD-9-CM
560.9 Intestinal obstruct NOS
Approximate The match is approximate rather than exact.

Code History & ChangesHistory

Replacement K56.609 replaces the following previously assigned code(s):

  • K56.60 - Unspecified intestinal obstruction
FY 2019AddedAdded to the ICD-10-CM code setEffective October 1, 2018.
FY 2020–2026No changes
FY 2027CurrentCurrent code set, no changesEffective October 1, 2026 through September 30, 2027.

Questions About K56.609Overview

Is K56.609 (Unspecified intestinal obstruction) a billable code?

Yes. This is a billable ICD-10-CM code, specific enough to report unspecified intestinal obstruction, unspecified as to partial versus complete obstruction on HIPAA-covered claims from October 1, 2026 through September 30, 2027.

What MS-DRG does K56.609 group to?

When unspecified intestinal obstruction, unspecified as to partial versus complete obstruction is the principal diagnosis on an inpatient stay, it groups to MS-DRG 793, 791, 389, 388, 390, with relative weights from 0.5403 to 4.2192 depending on complications. Higher weights mean higher Medicare reimbursement.

Is K56.609 a CC or MCC?

CMS lists K56.609 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 29 closely related codes in its exclusion list.

Can K56.609 be reported with E84.11?

Not as a rule. The Excludes1 note at K56, which applies to K56.609, lists "cystic fibrosis with meconium ileus (E84.11)". 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).

What is the ICD-9 equivalent of K56.609?

Under the General Equivalence Mappings, unspecified intestinal obstruction, unspecified as to partial versus complete obstruction converts to ICD-9-CM 560.9 (intestinal obstruct NOS). The mapping is approximate, so confirm the match fits the documentation.

What HCC is K56.609?

K56.609 (unspecified intestinal obstruction, unspecified as to partial versus complete obstruction) maps to CMS-HCC Category 78 (Intestinal Obstruction/Perforation), commonly written as HCC 78, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 33 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.

Does K56.609 risk-adjust for Medicare Advantage payment?

Yes. When documented and reported on a Medicare Advantage encounter, K56.609 adds a risk adjustment factor of about 0.326 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.326 to 0.688 depending on the payment segment). A more severe related category (HCC 77) supersedes it when both are reported. See the full factor table on the HCC 78 category page.