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K67 ICD-10-CM Code: Disorders of peritoneum in infectious diseases classified elsewhere

K67 maps to CMS-HCC V28 78. A source-labeled RAF reference is available. Documentation must support MEAT. MEAT criteria · RAF Calculator · free HCC coding tools

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FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Diseases of peritoneum and retroperitoneum (K65-K68)

K67

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

Disorders of peritoneum in infectious diseases classified elsewhere

Inflammation or infection of the peritoneum (the lining around abdominal organs) caused by an infectious disease classified elsewhere in the medical record.

Buddy the Bee presenting code insight

Buddy Insight

This code represents peritoneal complications secondary to infectious diseases classified elsewhere, requiring dual coding to capture both the underlying infection and peritoneal involvement.

CMS-HCC V28

HCC 78

Code-level coefficient reference

CMS-HCC V24

N/A

—

Not mapped

ACA/HHS

HCC 042

Code-level coefficient reference

ESRD/PACE

HCC 33

Code-level coefficient reference

RXHCC

N/A

—

Not mapped

Code Book Path

Official
K6Diseases of peritoneum and retroperitoneum (K65-K68)
K67Disorders of peritoneum in infectious diseases classified elsewhere

Inclusion Terms

Official

ICD-10-CM does not list inclusion terms for K67 in this effective period.

Excludes 2

Official

ICD-10-CM does not list Excludes 2 notes for K67 in this effective period.

Related Child Codes

Official

ICD-10-CM does not list child codes under K67 for this display context.

Includes

Official

ICD-10-CM does not list Includes notes for K67 in this effective period.

Excludes 1

Official
  • peritonitis in chlamydia (A74.81)
  • peritonitis in diphtheria (A36.89)
  • peritonitis in gonococcal (A54.85)
  • peritonitis in syphilis (late) (A52.74)
  • peritonitis in tuberculosis (A18.31)

Code First

Official
  • underlying disease, such as:
  • congenital syphilis (A50.0)
  • helminthiasis (B65.0 -B83.9)

Use Additional

Official

ICD-10-CM does not list Use Additional Code instructions for K67 in this effective period.

Code Also

Official

ICD-10-CM does not list Code Also instructions for K67 in this effective period.

Buddy Documentation Tip

HCC Buddy guidance
Documentation of peritoneal disorder/inflammation
Clear identification of underlying infectious disease
Evidence linking peritoneal condition to the infection
Coding of primary infectious disease elsewhere

MEAT Support

HCC Buddy guidance
Documentation of peritoneal disorder/inflammation
Clear identification of underlying infectious disease
Evidence linking peritoneal condition to the infection
Coding of primary infectious disease elsewhere

Audit Caution

HCC Buddy guidance
Failing to code the underlying infectious disease first
Using when peritonitis is the primary condition
Missing the causal relationship documentation
Incorrectly sequencing the codes

Common Mistakes

HCC Buddy guidance
K65.0 — Primary acute peritonitis not secondary to other infections
K65.9 — Unspecified peritonitis without identified infectious cause
A41.9 — Primary sepsis code should be sequenced first
B99 — Other infectious diseases require specific organism coding

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 K67 an HCC code?

Yes. K67 (Disorders of peritoneum in infectious diseases classified elsewhere) 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: K67 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
K67
Description
Disorders of peritoneum in infectious diseases classified elsewhere
HCC (V28)
HCC 78 — Intestinal Obstruction/Perforation
RAF reference coefficient
0.326
Billable
Yes
Payment year
2026

HCC Category Mapping

V28HCC 78, Intestinal Obstruction/Perforation
0.326
ESRDHCC 33, Intestinal Obstruction/Perforation
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 K67 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →

MEAT Criteria for K67

For K67 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 K67 during that encounter, not just copy-forwarded from a problem list.

Coder workflow notes

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What This Code Means

K67 is the ICD-10-CM diagnosis code for disorders of peritoneum in infectious diseases classified elsewhere. Inflammation or infection of the peritoneum (the lining around abdominal organs) caused by an infectious disease classified elsewhere in the medical record. K67 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering diseases of peritoneum and retroperitoneum (k65-k68).

Under the CMS-HCC V28 risk adjustment model, K67 maps to Intestinal Obstruction/Perforation (HCC 78) with a source-labeled community, non-dual, aged reference coefficient of 0.326. No V24 mapping is shown for K67; 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 code requires a secondary code to identify the underlying infectious disease causing the peritoneal disorder. Because K67 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 K67 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.

Coding Tips

  • •This code requires a secondary code to identify the underlying infectious disease causing the peritoneal disorder
  • •Use this code when the peritoneal involvement is a manifestation of another classified infectious condition

Clinical Significance

This code represents peritoneal complications secondary to infectious diseases classified elsewhere, requiring dual coding to capture both the underlying infection and peritoneal involvement. The condition indicates systemic infection with abdominal complications, necessitating aggressive treatment of both conditions.

Documentation Requirements

  • ✓Documentation of peritoneal disorder/inflammation
  • ✓Clear identification of underlying infectious disease
  • ✓Evidence linking peritoneal condition to the infection
  • ✓Coding of primary infectious disease elsewhere
  • ✓Clinical manifestations of both conditions
  • ✓Treatment addressing both infectious and peritoneal components
  • ✓Provider assessment of causal relationship
  • ✓Exclusion of primary peritonitis diagnoses

Excludes 1, Do NOT code together

  • peritonitis in chlamydia (A74.81)
  • peritonitis in diphtheria (A36.89)
  • peritonitis in gonococcal (A54.85)
  • peritonitis in syphilis (late) (A52.74)
  • peritonitis in tuberculosis (A18.31)

Code First

  • underlying disease, such as:
  • congenital syphilis (A50.0)
  • helminthiasis (B65.0 -B83.9)

Commonly Confused Codes

  • •K65.0: Primary acute peritonitis not secondary to other infections
  • •K65.9: Unspecified peritonitis without identified infectious cause
  • •A41.9: Primary sepsis code should be sequenced first
  • •B99: Other infectious diseases require specific organism coding
  • •K68.19: Retroperitoneal abscess is anatomically distinct

Code Hierarchy

└K67Disorders of peritoneum in infectious diseases classified elsewhere
└K67Disorders of peritoneum in infectious diseases classified elsewhere

Because K67 maps to an HCC category, the documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) before the diagnosis is used for risk adjustment.

K67 maps to CMS-HCC V28 category 78, Intestinal Obstruction/Perforation. See the ICD-10 to HCC mapping hub for how the V28 crosswalk works. The mapping identifies a payment HCC category for K67. Review its source-labeled HCC coefficient above, check the RAF Calculator with complete member context for CMS-HCC V28 PY2026, and confirm the documentation the chart needs before the code is submitted. HCC Buddy shows no RAF score unless every required source and calculation check passes.

Work K67 in HCC Buddy

Open K67 in the Code Book for the full Index-to-Tabular path, MEAT checklist, and V28 HCC mapping, or in the Encoder to code from a keyword search. Pro includes 7 days to try everything, no card required.

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