K94.13

Billable

Enterostomy malfunction

HCC Category Mapping

V28HCC 463 — Artificial Openings for Feeding or Elimination

0.233

V24HCC 188 — Artificial Openings for Feeding or Elimination

0.570

ESRDHCC 188 — Artificial Openings for Feeding or Elimination

0.000

What This Code Means

A functional problem with the enterostomy, such as blockage, leakage, or improper functioning of the stoma.

Coding Tips

•Specify the type of malfunction in documentation (obstruction, leakage, stenosis, prolapse, etc.)
•Review imaging or endoscopy findings to confirm the specific malfunction

Clinical Significance

Enterostomy malfunction represents mechanical problems with small bowel stoma function that can significantly impact nutritional status and fluid balance. These complications often require specialized intervention and may necessitate surgical revision to restore proper function.

Documentation Requirements

✓Presence of enterostomy documented
✓Specific type of malfunction identified
✓Impact on stoma output and function
✓Patient symptoms and complications
✓Assessment of stoma appearance and viability
✓Interventions attempted or planned
✓Need for surgical revision assessment
✓Nutritional and fluid status impact

Commonly Confused Codes

K94.10 — Unspecified enterostomy complication when malfunction is documented K94.03 — Colostomy malfunction for large bowel stomas K91.89 — Other postoperative complications when not stoma-specific K94.19 — Other enterostomy complications for non-mechanical issues

Code Hierarchy

└K94Complications of artificial openings of the digestive system └K94.1Enterostomy complications └K94.13Enterostomy malfunction

└K94.13Enterostomy malfunction