2024 ICD-10-CM Diagnosis Code K31.1

Approximate Synonyms

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

• Acquired hypertrophic pyloric stenosis
• Acquired nonhypertrophic constriction of pylorus
• Acquired obstruction of pylorus
• Acquired pyloric constriction
• Acquired pyloric stricture
• Adult hypertrophic pyloric stenosis
• Gastric outlet obstruction due to gallstone
• Peptic ulcer with hemorrhage, with perforation AND with obstruction
• Pyloric antral stenosis
• Pyloric obstruction
• Pyloric obstruction
• Pyloric obstruction
• Pyloric stenosis
• Pyloric stenosis
• Pyloric stenosis
• Pyloric stenosis
• Pyloric stenosis
• Pyloric stenosis

Clinical Information

• Pyloric Stenosis

  narrowing of the pyloric canal with varied etiology. a common form is due to muscle hypertrophy (pyloric stenosis, hypertrophic) seen in infants.

• Pyloric Stenosis, Hypertrophic

  narrowing of the pyloric canal due to hypertrophy of the surrounding circular muscle. it is usually seen in infants or young children.

• Hypertrophy

  general increase in bulk of a part or organ due to cell enlargement and accumulation of fluids and secretions, not due to tumor formation, nor to an increase in the number of cells (hyperplasia).

Code Edits

The Medicare Code Editor (MCE) detects and reports errors in the coding of claims data. The following ICD-10-CM Code Edits are applicable to this code:

• Adult diagnoses - The Medicare Code Editor detects inconsistencies in adult cases by checking a patient's age and any diagnosis on the patient's record. The adult code edits apply to patients age range is 15–124 years inclusive (e.g., senile delirium, mature cataract).

K31.1 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
380	COMPLICATED PEPTIC ULCER WITH MCC	06	1.9485
381	COMPLICATED PEPTIC ULCER WITH CC	06	1.073
382	COMPLICATED PEPTIC ULCER WITHOUT CC/MCC	06	0.7571

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 K31.1 to ICD-9-CM

• ICD-9-CM Code: 537.0 - Acq pyloric stenosis

Patient Education

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.