Version 2024

2024 ICD-10-CM Diagnosis Code K91.86

Retained cholelithiasis following cholecystectomy

ICD-10-CM Code:: K91.86
ICD-10 Code for:: Retained cholelithiasis following cholecystectomy
Is Billable?: Yes - Valid for Submission
Chronic Condition Indicator: ^[1]: Not chronic
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Code Information
Clinical Classification
Tabular List of Diseases and Injuries
Index to Diseases and Injuries References
Diagnostic Related Groups Mapping
Convert to ICD-9 Code
Patient Education
Other Codes Used Similar Conditions
Code History

Code Classification

Diseases of the digestive system
(K00–K95)
- Other diseases of the digestive system
  (K90-K95)
  - Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classified
    (K91)

K91.86 is a billable diagnosis code used to specify a medical diagnosis of retained cholelithiasis following cholecystectomy. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024.

Clinical Classification

Clinical Category is Postprocedural or postoperative digestive system complication
CCSR Category Code: DIG024
Inpatient Default CCSR: Y - Yes, default inpatient assignment for principal diagnosis or first-listed diagnosis.
Outpatient Default CCSR: Y - Yes, default outpatient assignment for principal diagnosis or first-listed diagnosis.

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

- Retained - See Also: Retention;
- - cholelithiasis following cholecystectomy - K91.86
- - gallstones, following cholecystectomy - K91.86

- Retention - See Also: Retained;
- - cholelithiasis following cholecystectomy - K91.86
- - gallstones, following cholecystectomy - K91.86

K91.86 is grouped with 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
393	OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC	06	1.6196
394	OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC	06	0.9369
395	OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC	06	0.6475

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 K91.86 to ICD-9-CM

ICD-9-CM Code: 997.41 - Ret cholelh fol cholecys

Other ICD-10-CM Codes Commonly Used for Similar Conditions

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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.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.