K83.4
BillableSpasm of sphincter of Oddi
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is K83.4 an HCC code?
No. K83.4 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
K83.4 is the ICD-10-CM diagnosis code for spasm of sphincter of oddi. Involuntary muscle contractions of the sphincter of Oddi (the valve controlling bile flow into the small intestine), causing pain and digestive problems. K83.4 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).
K83.4 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.
This diagnosis is often clinical and may not have imaging confirmation; ensure documentation supports the diagnosis.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K83.4 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •This diagnosis is often clinical and may not have imaging confirmation; ensure documentation supports the diagnosis
- •Verify this is not secondary to another condition like pancreatitis or bile duct obstruction