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K50.819 ICD-10-CM Code: Crohn's disease of both small and large intestine with unspecified complications

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FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Noninfective enteritis and colitis (K50-K52)

K50.819

Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidance

Crohn's disease of both small and large intestine with unspecified complications

Crohn's disease affecting both the small and large intestines with complications that are not specifically identified or documented.

Buddy the Bee presenting code insight

Buddy Insight

Crohn's disease of both small and large intestine with unspecified complications is the least specific complication code for ileocolonic Crohn's disease.

CMS-HCC V28

HCC 80

RAF 0.550

CMS-HCC V24

HCC 35

RAF 0.308

ACA/HHS

HCC 48

Varies by metal level

ESRD/PACE

HCC 35

RAF 0.048

RXHCC

HCC 67

RAF 0.494

Code Book Path

Official
K50.8Crohn's disease of both small and large intestine
K50.81Crohn's disease of both small and large intestine with complications
K50.819Crohn's disease of both small and large intestine with unspecified complications

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for K50.819 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for K50.819 in this effective period.

Related Child Codes

Official
K50.811Crohn's disease of both small and large intestine with rectal bleeding
K50.812Crohn's disease of both small and large intestine with intestinal obstruction
K50.813Crohn's disease of both small and large intestine with fistula
K50.814Crohn's disease of both small and large intestine with abscess
K50.818Crohn's disease of both small and large intestine with other complication

Includes

Official

ICD-10-CM does not list Includes notes for K50.819 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for K50.819 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for K50.819 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for K50.819 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for K50.819 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Provider documentation of ileocolonic Crohn's disease with complications present
Both small and large intestine involvement confirmed
Documentation indicating complications exist even if type is unknown
Provider query attempt documented

MEAT Support

HCC Buddy guidance
Provider documentation of ileocolonic Crohn's disease with complications present
Both small and large intestine involvement confirmed
Documentation indicating complications exist even if type is unknown
Provider query attempt documented

Audit Caution

HCC Buddy guidance
Accepting the unspecified code without attempting to clarify the complication through provider query
Using this code when diagnostic reports or procedure notes identify the complication
Confusing 'unspecified' (unknown) with 'other' (known but not standard) complications
Not reviewing the full record for clues about the complication type

Common Mistakes

HCC Buddy guidance
K50.80 — Crohn's disease of both sites without complications: no complications present
K50.818 — Crohn's disease of both sites with other complication: complication IS identified
K50.811-K50.814 — Specific complication codes: use when the complication is known
K50.919 — Crohn's disease, unspecified, with unspecified complications: both site and complication unspecified

Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →

Is K50.819 an HCC code?

Yes. K50.819 (Crohn's disease of both small and large intestine with unspecified complications) maps to Crohn's Disease (Regional Enteritis) under the CMS-HCC V28 risk adjustment model (and Inflammatory Bowel Disease under V24), with a community non-dual aged RAF of 0.550. It is billable for payment year 2026.

Coder answer: K50.819 is billable and maps to V28 HCC 80, Crohn's Disease (Regional Enteritis). Open it in the Code Book for the tabular path, RAF, and MEAT checklist.

Code
K50.819
Description
Crohn's disease of both small and large intestine with unspecified complications
HCC (V28)
HCC 80 — Crohn's Disease (Regional Enteritis)
RAF
0.550
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 80, Crohn's Disease (Regional Enteritis)
0.550
V24HCC 35, Inflammatory Bowel Disease
0.308
ESRDHCC 35, Inflammatory Bowel Disease
0.048
RxHCCHCC 67, Inflammatory Bowel Disease
0.494

Each model's RAF is its CMS base weight for that model's standard population, so weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.

Work K50.819 in the Code Book — tabular path, V28 RAF, and MEAT checklist →

MEAT Criteria for K50.819

For K50.819 to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.

  • MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
  • EEvaluate: test results, medication response, or physical findings reviewed by the provider
  • AAssess: explicit mention in the assessment or plan with acknowledgment of status
  • TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis

Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed K50.819 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

K50.819 is the ICD-10-CM diagnosis code for crohn's disease of both small and large intestine with unspecified complications. Crohn's disease affecting both the small and large intestines with complications that are not specifically identified or documented. K50.819 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering noninfective enteritis and colitis (k50-k52).

Under the CMS-HCC V28 risk adjustment model, K50.819 maps to Crohn's Disease (Regional Enteritis) (HCC 80) with a community, non-dual, aged base RAF weight of 0.550. Under the older CMS-HCC V24 model, K50.819 maps to Inflammatory Bowel Disease (HCC 35) with a community, non-dual, aged base RAF weight of 0.308. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.

Use this code only when complications are present but not clearly specified in the documentation. Because K50.819 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K50.819 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •Use this code only when complications are present but not clearly specified in the documentation
  • •Query the provider if possible to identify the specific complication for more precise coding

Clinical Significance

Crohn's disease of both small and large intestine with unspecified complications is the least specific complication code for ileocolonic Crohn's disease. It indicates complications exist but their nature is not documented. This code should trigger a provider query for clarification, as the extensive disease location combined with complications typically has well-documented manifestations.

Documentation Requirements

  • ✓Provider documentation of ileocolonic Crohn's disease with complications present
  • ✓Both small and large intestine involvement confirmed
  • ✓Documentation indicating complications exist even if type is unknown
  • ✓Provider query attempt documented
  • ✓Treatment plan that may hint at the complication type

Commonly Confused Codes

  • •K50.80: Crohn's disease of both sites without complications: no complications present
  • •K50.818: Crohn's disease of both sites with other complication: complication IS identified
  • •K50.811-K50.814: Specific complication codes: use when the complication is known
  • •K50.919: Crohn's disease, unspecified, with unspecified complications: both site and complication unspecified

Child Codes

K50.811Crohn's disease of both small and large intestine with rectal bleeding
HCC 80
K50.812Crohn's disease of both small and large intestine with intestinal obstruction
HCC 78
K50.813Crohn's disease of both small and large intestine with fistula
HCC 80
K50.814Crohn's disease of both small and large intestine with abscess
HCC 80
K50.818Crohn's disease of both small and large intestine with other complication
HCC 80
K50.819Crohn's disease of both small and large intestine with unspecified complications
HCC 80

Code Hierarchy

└K50Crohn's disease [regional enteritis]└K50.8Crohn's disease of both small and large intestine└K50.81Crohn's disease of both small and large intestine with complications└K50.819Crohn's disease of both small and large intestine with unspecified complications
└K50.819Crohn's disease of both small and large intestine with unspecified complications

Because K50.819 maps to a payment HCC, the documentation must also satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's risk adjustment score.

K50.819 maps to CMS-HCC V28 category 80, Crohn's Disease (Regional Enteritis). See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. Because K50.819 carries a payment HCC, you can see what it adds to a RAF score and check the documentation the chart needs before it is submitted.

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