K56.2
BillableVolvulus
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is K56.2 an HCC code?
Yes. K56.2 maps to Intestinal Obstruction/Perforation under the CMS-HCC V28 risk adjustment model (and Intestinal Obstruction/Perforation under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. 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.
MEAT Criteria for K56.2
For K56.2to 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 K56.2 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
K56.2 is the ICD-10-CM diagnosis code for volvulus. A twisting of the intestine on itself, cutting off blood supply and causing a blockage. This is a surgical emergency that requires immediate intervention. K56.2 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, K56.2 maps to Intestinal Obstruction/Perforation (HCC 78) with a community, non-dual, aged base RAF weight of 0.326. Under the older V24 model, K56.2 mapped to the same category but with a base RAF weight of 0.219 — V28 recalibrated weights across the entire model. 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.
Volvulus is typically an acute condition requiring emergency surgery; ensure documentation reflects the urgency. Because K56.2 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 K56.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Volvulus is typically an acute condition requiring emergency surgery; ensure documentation reflects the urgency
- •Specify the site if documented (sigmoid, cecal, or other) as this affects treatment and prognosis
Clinical Significance
K56.2 represents volvulus, a life-threatening condition where the bowel twists on itself, cutting off blood supply and causing complete obstruction. This surgical emergency requires immediate intervention to prevent bowel necrosis, perforation, and sepsis, with high morbidity and mortality if treatment is delayed.
Documentation Requirements
- ✓Imaging studies showing characteristic twisted bowel appearance
- ✓Clinical presentation of acute bowel obstruction with severe pain
- ✓Documentation of coffee bean sign or other pathognomonic findings
- ✓Assessment of bowel viability and signs of ischemia
- ✓Surgical consultation and emergency intervention
- ✓Documentation of specific bowel segment involved (cecal, sigmoid, etc.)
- ✓Evidence of complete obstruction and compromised blood flow
- ✓Post-operative monitoring and complications
Excludes 2 — Not included here, may code separately
- volvulus of duodenum (K31.5)
Commonly Confused Codes
- •K56.1 — Intussusception (telescoping rather than twisting mechanism)
- •K56.60 — Complete intestinal obstruction unspecified (when twisting mechanism not documented)
- •K55.0 — Acute vascular disorders of intestine (vascular compromise secondary to mechanical cause)
- •K92.2 — Gastrointestinal hemorrhage (bleeding complication rather than primary diagnosis)
- •K56.69 — Other intestinal obstruction (when volvulus not specifically identified)