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A04.7 vs K55.3

A04.7 (Enterocolitis due to Clostridium difficile) compared with K55.3 (Necrotizing enterocolitis), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).

Can these codes be reported together?

Yes, when both are documented. K55.3 carries an Excludes2 note covering A04.7: “necrotizing enterocolitis due to Clostridium difficile (A04.7-)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

Side by side

A04.7Enterocolitis due to Clostridium difficileK55.3Necrotizing enterocolitis
Billing statusNon-billable header

Report instead: A04.71, A04.72

Non-billable header

Report instead: K55.30, K55.31, K55.32, K55.33

ClassificationA00-B99 — Certain Infectious and Parasitic Diseases (A00-B99)K00-K95 — Diseases of the Digestive System (K00-K95)
DefinitionEnterocolitis due to Clostridium difficile is a non-billable ICD-10-CM category code (A04.7).Necrotizing enterocolitis is a non-billable ICD-10-CM category code (K55.3).
Includes
Clostridioides difficile colitis
Foodborne intoxication by Clostridium difficile
Pseudomembraneous colitis
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Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources