K56.0 ICD-10-CM Code: Paralytic ileus
K56.0 maps to CMS-HCC V28 78. A source-labeled RAF reference is available. Confirm the documented diagnosis and applicable coding requirements. 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)
K56.0
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceParalytic ileus
A temporary loss of normal intestinal muscle contractions that prevents food and waste from moving through the bowels, often occurring after surgery.
Buddy Insight
K56.
CMS-HCC V28
MappedHCC 78
Coefficient HCC 78: 0.326 (Community Non-Dual Aged (CNA))
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
MappedHCC 045
Code-level coefficient reference
ESRD/PACE
MappedHCC 33
Code-level coefficient reference
RXHCC
N/A—
Not mapped
Code Book Path
Inclusion Terms
Official- Paralysis of bowel
- Paralysis of colon
- Paralysis of intestine
Excludes 2
Official- certain conditions originating in the perinatal period (P04-P96)Inherited from K00-K95, K56
- certain infectious and parasitic diseases (A00-B99)Inherited from K00-K95, K56
- complications of pregnancy, childbirth and the puerperium (O00-O9A)Inherited from K00-K95, K56
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)Inherited from K00-K95, K56
- endocrine, nutritional and metabolic diseases (E00-E88)Inherited from K00-K95, K56
- injury, poisoning and certain other consequences of external causes (S00-T88)Inherited from K00-K95, K56
- neoplasms (C00-D49)Inherited from K00-K95, K56
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)Inherited from K00-K95, K56
- stenosis of anus or rectum (K62.4)Inherited from K00-K95, K56
Related Codes
Includes
OfficialNo Includes notes are included in this display for K56.0. Check the code and parent instructions in the Code Book.
Excludes 1
Official- gallstone ileus (K56.3)
- ileus NOS (K56.7)
- obstructive ileus NOS (K56.69-)
- congenital stricture or stenosis of intestine (Q41-Q42)Inherited from K56
- cystic fibrosis with meconium ileus (E84.11)Inherited from K56
- ischemic stricture of intestine (K55.1)Inherited from K56
- meconium ileus NOS (P76.0)Inherited from K56
- neonatal intestinal obstructions classifiable to P76.-Inherited from K56
- obstruction of duodenum (K31.5)Inherited from K56
- postprocedural intestinal obstruction (K91.3-)Inherited from K56
Code First
OfficialNo Code First sequencing instructions are included in this display for K56.0. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for K56.0. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for K56.0. 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 K56.0 an HCC code?
Yes. K56.0 (Paralytic ileus) maps to HCC 78, Intestinal Obstruction/Perforation under the CMS-HCC V28 risk adjustment model, with a source-labeled community non-dual aged reference coefficient of 0.326. 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: K56.0 is billable and maps to V28 HCC 78, Intestinal Obstruction/Perforation. Open it in the Code Book for the tabular path, RAF, and MEAT checklist.
- Code
- K56.0
- Description
- Paralytic ileus
- HCC (V28)
- HCC 78 — Intestinal Obstruction/Perforation
- RAF reference coefficient
- 0.326
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
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 K56.0 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for K56.0
For K56.0, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
K56.0 is the ICD-10-CM diagnosis code for paralytic ileus. A temporary loss of normal intestinal muscle contractions that prevents food and waste from moving through the bowels, often occurring after surgery. K56.0 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).
Under the CMS-HCC V28 risk adjustment model, K56.0 maps to Intestinal Obstruction/Perforation (HCC 78) with a source-labeled community, non-dual, aged reference coefficient of 0.326. For CY2026 non-PACE Medicare Advantage, CMS uses 100% of the 2024 CMS-HCC model (V28). PACE uses a separate model blend. 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.
Document the cause (post-surgical, medication-induced, etc.) and duration to support medical necessity. For K56.0, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule. 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 K56.0 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
Clinical Significance
K56.0 represents paralytic ileus, a serious condition where intestinal motility ceases, often occurring postoperatively or due to electrolyte imbalances, medications, or systemic illness. This condition can lead to bowel distention, perforation, and sepsis if not promptly managed, requiring close monitoring and intervention.
Documentation Requirements
- ✓Documentation of absent or severely reduced bowel sounds
- ✓Clinical evidence of intestinal paralysis (distention, lack of passage of gas/stool)
- ✓Imaging showing dilated bowel loops without mechanical obstruction
- ✓Identification of underlying cause (post-surgical, medication-induced, metabolic)
- ✓Documentation excluding mechanical obstruction
- ✓Evidence of conservative or interventional management
- ✓Monitoring of electrolytes and fluid balance
- ✓Assessment of complications or risk factors
Excludes 1, Do NOT code together
Commonly Confused Codes
- •K56.7: Ileus unspecified (when paralytic nature not specifically documented)
- •K56.60: Partial intestinal obstruction unspecified (mechanical rather than paralytic)
- •K31.84: Gastroparesis (stomach-specific rather than intestinal)
- •K92.0: Hematemesis (bleeding rather than motility disorder)
- •R14.0: Abdominal distention (symptom rather than specific diagnosis)