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K59.3 ICD-10-CM Code: Megacolon, not elsewhere classified

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FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Other diseases of intestines (K55-K64)

K59.3

Header CodeICD-10-CMOfficial ICD-10-CMCodebook guidance

Megacolon, not elsewhere classified

Megacolon, not elsewhere classified

CMS-HCC V28

0

0

RAF 0

CMS-HCC V24

0

0

RAF 0

ACA/HHS

0

0

RAF 0

ESRD/PACE

0

0

RAF 0

RXHCC

0

0

RAF 0

Code Trumping

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Code Book Path

Official
K59Other functional intestinal disorders
K59.3Megacolon, not elsewhere classified

Inclusion Terms

Official
  • Dilatation of colon

Excludes 2

Official
  • functional disorders of stomach (K31.-)

Related Child Codes

Official
K59.31Toxic megacolon
K59.39Other megacolon

Includes

Official

ICD-10-CM does not list Includes notes for K59.3 in this effective period.

Excludes 1

Official
  • congenital megacolon (aganglionic) (Q43.1)
  • megacolon (due to) (in) Chagas' disease (B57.32)
  • megacolon (due to) (in) Clostridium difficile (A04.7-)
  • megacolon (due to) (in) Hirschsprung's disease (Q43.1)

Code First

Official
  • , if applicable (T51-T65) to identify toxic agent

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for K59.3 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for K59.3 in this effective period.

Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.

Coder workflow notes

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What This Code Means

K59.3 is the ICD-10-CM diagnosis code for megacolon, not elsewhere classified. K59.3 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).

Header codes like K59.3 cannot be reported on claims directly, they organize child codes that share clinical context but the actual diagnosis must be coded to the highest level of specificity supported by the documentation. Coders should look at K59.3's child codes and select the one that matches the patient's documented presentation, since payers reject header codes submitted as the primary diagnosis. For risk adjustment workflows, header codes never contribute to a Medicare Advantage member's RAF score on their own; only billable child codes that happen to map to a payment HCC affect risk-adjusted plan payments.

HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K59.3 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Excludes 1, Do NOT code together

  • congenital megacolon (aganglionic) (Q43.1)
  • megacolon (due to) (in) Chagas' disease (B57.32)
  • megacolon (due to) (in) Clostridium difficile (A04.7-)
  • megacolon (due to) (in) Hirschsprung's disease (Q43.1)

Code First

  • , if applicable (T51-T65) to identify toxic agent

Child Codes

Code Hierarchy

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