K80.51
BillableCalculus of bile duct without cholangitis or cholecystitis with obstruction
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is K80.51 an HCC code?
No. K80.51 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
K80.51 is the ICD-10-CM diagnosis code for calculus of bile duct without cholangitis or cholecystitis with obstruction. Gallstones in the bile duct without inflammation of the gallbladder or bile duct infection, but with blockage of bile flow. K80.51 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering disorders of gallbladder, biliary tract and pancreas (k80-k87).
K80.51 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Confirm documentation shows obstruction but explicitly excludes cholecystitis and cholangitis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K80.51 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Confirm documentation shows obstruction but explicitly excludes cholecystitis and cholangitis
- •The obstruction is caused solely by the stone, not by inflammation