2027 ICD-10-CM Diagnosis Code K94.09Other complications of colostomy
ICD-10-CM Codes›K00–K95›K90-K95›K94
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 463
- Not Chronic
K94.09 is a billable ICD-10-CM diagnosis code for other complications of colostomy. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 393 through 395. 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 10 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Postprocedural or postoperative digestive system complication.
For Medicare Advantage risk adjustment, K94.09 maps to CMS-HCC Category 463 (Artificial Openings for Feeding or Elimination) under the V28 model, adding a risk factor of about 0.673 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
K94.09 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.
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.
- Colostomy necrosis
- Colostomy prolapse
- Complication of colostomy
- Enterocutaneous fistula
- Enterostomy prolapse
- External large bowel fistula
- Fistula of colostomy
- Fistula of enterostomy
- Gangrene of colostomy
- Gastrointestinal fistula following surgical procedure
- Irritant contact dermatitis due to colostomy
- Irritant contact dermatitis due to stoma
- Ischemia of colostomy
- Ischemia of stoma
- Necrosis of stoma
- Paracolostomy hernia
- Parastomal hernia
- Peristomal dermatitis
- Peristomal skin complication
- Polyp of colostomy site
- Postoperative fistula
- Retraction of colostomy
- Retraction of stoma
- Stomal polyp
- Stomal prolapse
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K94.09: its own notes plus those printed at Chapter 11. A note printed at a category, block or chapter applies to every code under it.
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.
- 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 K94.09, its category, or a range that includes it.
Excludes1 2
These codes carry an Excludes1 note naming K94.09: they are not reported together with it, unless the two conditions are unrelated.
Excludes2 5
These codes carry an Excludes2 note naming K94.09: its condition is not part of those codes, and both may be reported when the patient has both.
- K62 Other diseases of anus and rectumcolostomy and enterostomy malfunction (K94.0-, K94.1-) names K94.0-, which includes this code
- K91 Intraoperative and postprocedural complications and disorders of digestive system, not elsewhere classifiedcomplications of artificial opening of digestive system (K94.-) names K94.-, which includes this code
- Block T80-T88 Complications of surgical and medical care, not elsewhere classifiedcolostomy malfunction (K94.0-) names K94.0-, which includes this code
- Block T80-T88 Complications of surgical and medical care, not elsewhere classifiedostomy complications (J95.0-, K94.-, N99.5-) names K94.-, which includes this code
- T81 Complications of procedures, not elsewhere classifiedostomy complications (J95.0-, K94.-, N99.5-) names K94.-, which includes this code
Index to Diseases and InjuriesGuidance
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Ostomy
An ostomy is surgery to create an opening (stoma) from an area inside the body to the outside. It treats certain diseases of the digestive or urinary systems. It can be permanent, when an organ must be removed. It can be temporary, when the organ needs time to heal. The organ could be the small intestine, colon, rectum, or bladder.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K94.09 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K94.09Overview
What is the ICD-10 code for other complications of colostomy?
The ICD-10-CM code for other complications of colostomy is K94.09 (sometimes written as K9409). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K94.09 (Colostomy complications) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report other complications of colostomy on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K94.09 group to?
When other complications of colostomy is the principal diagnosis on an inpatient stay, it groups to MS-DRG 394, 395, 393, with relative weights from 0.6379 to 1.5877 depending on complications. Higher weights mean higher Medicare reimbursement.
Is K94.09 a CC or MCC?
CMS lists K94.09 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 10 closely related codes in its exclusion list.
What is the ICD-9 equivalent of K94.09?
Under the General Equivalence Mappings, other complications of colostomy converts to ICD-9-CM 569.69 (colstmy/enteros comp NEC). The mapping is approximate, so confirm the match fits the documentation.
What HCC is K94.09?
K94.09 (other complications of colostomy) maps to CMS-HCC Category 463 (Artificial Openings for Feeding or Elimination), commonly written as HCC 463, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 188 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 K94.09 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, K94.09 adds a risk adjustment factor of about 0.673 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.526 to 0.947 depending on the payment segment). HCC 463 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 463 category page.
