What is ICD-10 code K50.919?

K50.919 is the ICD-10-CM diagnosis code for Crohn's disease, unspecified, with unspecified complications. Crohn's disease of unspecified location with complications that are present but not specifically identified or documented. It belongs to the ICD-10-CM chapter for diseases of the digestive system (k00-k95). K50.919 is a billable code, meaning it can be reported on a claim as a primary or secondary diagnosis when supported by documentation. K50.919 is part of the FY2026 ICD-10-CM code set published by the CMS National Center for Health Statistics and used on Medicare, Medicaid, and commercial claims in the United States.

Yes. K50.919 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. K50.919 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.

Which HCC does K50.919 map to under V28?

K50.919 maps to CMS-HCC V28 HCC 80 (Crohn's Disease (Regional Enteritis)). The category numbers, labels, and conditions come from the CMS-HCC V28 model file for payment year 2026.

2026 ICD-10-CM K50.919: Crohn's disease

K50.919 maps to CMS-HCC V28 80. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · HCC coding software

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Code lookupK50.919Effective periodFY2026 Apr Update (Apr 1-Sep 30)

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

K50.919

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

Crohn's disease, unspecified, with unspecified complications

Crohn's disease of unspecified location with complications that are present but not specifically identified or documented.

Buddy Insight

Crohn's disease, unspecified, with unspecified complications is the least specific code in the entire Crohn's disease family, with neither the disease location nor the complication type identified.

CMS-HCC V28

Mapped

HCC 80

Crohn's Disease (Regional Ent...

Code-level coefficient reference

CMS-HCC V24

Historical

Not used for standard CY2026 Medicare Advantage payment. Select a historical period to review V24.

Not used for CY2026 payment

ACA/HHS

Mapped

HCC 048

HHS-HCC 048 adult, RAF varies...

Code-level coefficient reference

ESRD/PACE

Mapped

HCC 35

Inflammatory Bowel Disease

Code-level coefficient reference

RXHCC

Mapped

HCC 67

Inflammatory Bowel Disease

Code-level coefficient reference

Code Book Path

Official

K50.9Crohn's disease, unspecified

K50.91Crohn's disease, unspecified, with complications

K50.919Crohn's disease, unspecified, with unspecified complications

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for K50.919 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for K50.919 in this effective period.

Related Child Codes

Official

K50.911Crohn's disease, unspecified, with rectal bleeding

K50.912Crohn's disease, unspecified, with intestinal obstruction

K50.913Crohn's disease, unspecified, with fistula

K50.914Crohn's disease, unspecified, with abscess

K50.918Crohn's disease, unspecified, with other complication

Includes

Official

ICD-10-CM does not list Includes notes for K50.919 in this effective period.

Excludes 1

Official

ICD-10-CM does not list Excludes 1 notes for K50.919 in this effective period.

Code First

Official

ICD-10-CM does not list Code First sequencing instructions for K50.919 in this effective period.

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for K50.919 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for K50.919 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance

Provider documentation of Crohn's disease with complications present

Documentation that neither the site nor the complication type could be determined

Evidence of attempted provider queries for clarification

Treatment plan that may provide clues about both location and complication

MEAT Support

HCC Buddy guidance

Provider documentation of Crohn's disease with complications present

Documentation that neither the site nor the complication type could be determined

Evidence of attempted provider queries for clarification

Treatment plan that may provide clues about both location and complication

Audit Caution

HCC Buddy guidance

Accepting this doubly unspecified code without exhaustive review and provider queries

Using this code when any part of the record identifies the disease location or complication type

Not reviewing procedure notes, imaging studies, or pathology that would clarify specificity

Confusing this code with K50.90 (no complications) — K50.919 specifically indicates complications ARE present

Common Mistakes

HCC Buddy guidance

K50.90 — Crohn's disease, unspecified, without complications: no complications present

K50.918 — Crohn's disease, unspecified, with other complication: complication IS identified

K50.911-K50.914 — Specific complication codes: use when the complication type is known

K50.819 — Crohn's disease of both sites with unspecified complications: sites are specified

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 K50.919 an HCC code?

Yes. K50.919 (Crohn's disease, unspecified, with unspecified complications) maps to HCC 80, Crohn's Disease (Regional Enteritis) under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.550. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes. It is billable for payment year 2026.

Coder answer: K50.919 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: K50.919
Description: Crohn's disease, unspecified, with unspecified complications
HCC (V28): HCC 80 — Crohn's Disease (Regional Enteritis)
RAF reference coefficient: 0.550
Billable: Yes
Payment year: 2026

HCC Category Mapping

V28HCC 80, Crohn's Disease (Regional Enteritis)

0.550

ESRDHCC 35, Inflammatory Bowel Disease

Not separately weighted

RxHCCHCC 67, Inflammatory Bowel Disease

Not separately weighted

These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. 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 context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.

Work K50.919 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for K50.919

For K50.919 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 K50.919 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

K50.919 is the ICD-10-CM diagnosis code for crohn's disease, unspecified, with unspecified complications. Crohn's disease of unspecified location with complications that are present but not specifically identified or documented. K50.919 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, K50.919 maps to Crohn's Disease (Regional Enteritis) (HCC 80) with a source-labeled community, non-dual, aged reference coefficient of 0.550. No V24 mapping is shown for K50.919; use the applicable model and payment year when reviewing the V28 mapping. 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. Source-labeled code-level coefficients are references, not member totals. Actual contribution depends on complete member context, hierarchy and cleanup rules, interactions, and model year. HCC Buddy's RAF Calculator supports CMS-HCC V28 PY2026 and shows no score unless every required source and calculation check passes.

This is a default code when complications exist but are not clearly specified. Because K50.919 maps to an HCC category, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment. 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, source-labeled coefficient references, and MEAT documentation criteria for K50.919 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

•This is a default code when complications exist but are not clearly specified
•Query the provider to identify the specific complication for more accurate coding when possible

Clinical Significance

Crohn's disease, unspecified, with unspecified complications is the least specific code in the entire Crohn's disease family, with neither the disease location nor the complication type identified. This code represents a significant documentation deficiency and should always trigger provider queries for both site and complication clarification. It provides minimal clinical value while still contributing to risk adjustment in V24.

Documentation Requirements

✓Provider documentation of Crohn's disease with complications present
✓Documentation that neither the site nor the complication type could be determined
✓Evidence of attempted provider queries for clarification
✓Treatment plan that may provide clues about both location and complication
✓Documentation justifying why specificity could not be achieved

Commonly Confused Codes

•K50.90: Crohn's disease, unspecified, without complications: no complications present
•K50.918: Crohn's disease, unspecified, with other complication: complication IS identified
•K50.911-K50.914: Specific complication codes: use when the complication type is known
•K50.819: Crohn's disease of both sites with unspecified complications: sites are specified