K55.1 ICD-10-CM Code: Chronic vascular disorders of intestine
K55.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Other diseases of intestines (K55-K64)
K55.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceChronic vascular disorders of intestine
A long-term condition where blood vessels in the intestines are damaged or not functioning properly, reducing blood flow to the intestinal tissue.
Buddy Insight
Chronic vascular disorders of intestine indicates long-term compromised bowel blood supply requiring ongoing monitoring and management.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
Context neededHCC 042
Coefficient needs member context
ESRD/PACE
Context neededHCC 108
Coefficient needs member context
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Chronic ischemic colitis
- Chronic ischemic enteritis
- Chronic ischemic enterocolitis
- Ischemic stricture of intestine
- Mesenteric atherosclerosis
- Mesenteric vascular insufficiency
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from K00-K95, K55
- certain infectious and parasitic diseases (A00-B99)Inherited from K00-K95, K55
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from K00-K95, K55
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from K00-K95, K55
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from K00-K95, K55
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from K00-K95, K55
- neoplasms (C00-D49)Inherited from K00-K95, K55
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from K00-K95, K55
- angioectasia (angiodysplasia) duodenum (K31.81-)Inherited from K00-K95, K55
Related Codes
Includes
OfficialNo Includes notes are included in this display for K55.1. Check the code and parent instructions in the Code Book.
Excludes 1
Official- necrotizing enterocolitis of newborn (P77.-)Inherited from K55
Code First
OfficialNo Code First sequencing instructions are included in this display for K55.1. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for K55.1. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for K55.1. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
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 K55.1 an HCC code?
K55.1 has no mapping under the current CMS-HCC V28 community payment model. K55.1 has a separate mapping under the CMS-HCC ESRD model (HCC 108 (Vascular Disease)); the applicable result needs member context. K55.1 also appears in the HHS-HCC commercial risk model (HCC 042 (HHS-HCC 042 adult, RAF varies by metal level)), where the result depends on member context and is not a Medicare Advantage payment mapping.
- Code
- K55.1
- Description
- Chronic vascular disorders of intestine
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
Coder workflow notes
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What This Code Means
K55.1 is the ICD-10-CM diagnosis code for chronic vascular disorders of intestine. A long-term condition where blood vessels in the intestines are damaged or not functioning properly, reducing blood flow to the intestinal tissue. K55.1 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering other diseases of intestines (k55-k64).
K55.1 has no mapping under the current CMS-HCC V28 community payment model. K55.1 has a separate mapping under the CMS-HCC ESRD model (HCC 108 (Vascular Disease)); the applicable result needs member context. K55.1 also appears in the HHS-HCC commercial risk model (HCC 042 (HHS-HCC 042 adult, RAF varies by metal level)), where the result depends on member context and is not a Medicare Advantage payment mapping. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
This code is for chronic vascular issues; if acute ischemia is present, use K55.0 instead.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for K55.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This code is for chronic vascular issues; if acute ischemia is present, use K55.0 instead
- •Document the specific location (small intestine vs colon) if available for more precise coding
Clinical Significance
Chronic vascular disorders of intestine indicates long-term compromised bowel blood supply requiring ongoing monitoring and management. This condition represents established vascular disease with potential for acute exacerbations and complications requiring specialized gastroenterology care.
Documentation Requirements
- ✓Chronic abdominal symptoms documented
- ✓Evidence of long-term vascular compromise
- ✓Imaging showing chronic ischemic changes
- ✓Absence of acute infarction or necrosis
- ✓Underlying vascular pathology identified
- ✓Treatment history and response documented
- ✓Ongoing monitoring and management plan