Question 1

What is ICD-10 code K30?

Accepted Answer

K30 is the ICD-10-CM diagnosis code for functional dyspepsia. Persistent discomfort or pain in the upper abdomen after eating, without an identifiable structural cause. K30 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering diseases of esophagus, stomach and duodenum (k20-k31).

K30 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.

Functional dyspepsia is a diagnosis of exclusion; ensure serious conditions have been ruled out.

Question 2

Is K30 an HCC code?

Accepted Answer

No. K30 is a billable ICD-10-CM code but does not map to any payment HCC category under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can still be reported on Medicare Advantage encounter data submissions, but it does not contribute to the beneficiary's Risk Adjustment Factor (RAF) score and therefore does not affect the risk-adjusted capitation payment to the plan. V28 reached 100% phase-in for payment year 2026.

Question 3

Is K30 billable?

Accepted Answer

Yes. K30 is a billable ICD-10-CM code that can be reported on professional and institutional claims as a primary or secondary diagnosis when the provider documentation supports the specific condition described. Billable codes in ICD-10-CM are coded to the highest level of specificity available for the documented diagnosis. K30 is current for fiscal year 2026 and remains in the active CMS ICD-10-CM code set published by the National Center for Health Statistics.

Question 4

What is the V28 vs V24 difference for K30?

Accepted Answer

K30 does not map to a payment HCC under either the CMS-HCC V28 risk adjustment model or the older V24 model. V28 reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition. Because neither model rewards K30 with a risk adjustment factor, it contributes zero to a Medicare Advantage beneficiary's RAF score in either version. Coders should check whether provider documentation supports a more specific child code that does map to a payment HCC.

Question 5

What should coders know when reporting K30?

Accepted Answer

Functional dyspepsia is a diagnosis of exclusion; ensure serious conditions have been ruled out Document symptoms such as early satiety, postprandial fullness, epigastric pain, or burning

K30

Is K30 an HCC code?

What This Code Means

Coding Tips

Excludes 1 — Do NOT code together

Code Hierarchy

Open K30 in the Interactive Encoder