K91.1 (Postgastric surgery syndromes) compared with T81.83XA (Persistent postprocedural fistula, initial encounter), from the official CMS tabular data. Both may be reported when both conditions are documented (Excludes2).
Distinct conditions — both may be reported.
“intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)”
An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.
Source: CMS ICD-10-CM tabular instructional notes
Yes, when both are documented. T81.83XA carries an Excludes2 note covering K91.1: “intraoperative and postprocedural complications of specific body system (D78.-, E36.-, E89.-, G97.3-, G97.4, H59.3-, H59.-, H95.2-, H95.3, I97.4-, I97.5, J95, K91.-, L76.-, M96.-, N99.-)”
Excludes2 marks distinct conditions — both may be reported when both are documented.
| K91.1Postgastric surgery syndromes | T81.83XAPersistent postprocedural fistula, initial encounter | |
|---|---|---|
| Billing status | Billable | Billable |
| Classification | K00-K95 — Diseases of the Digestive System (K00-K95) | S00-T88 — Injury, Poisoning and Certain Other Consequences of External Causes (S00-T88) |
| Definition | Postgastric surgery syndromes is a billable ICD-10-CM diagnosis code (K91.1). | Persistent postprocedural fistula, initial encounter is a billable ICD-10-CM diagnosis code (T81.83A). |
| 7th character | — | The appropriate 7th character is to be added to each code from category T81 |
| Includes | Dumping syndrome Postgastrectomy syndrome Postvagotomy syndrome | — |
| Use additional code | — | code, if known, for site of fistula such as: anal fistula (K60.3-) anorectal fistula (K60.5-) |
Derived from the official CMS ICD-10-CM tabular data (FY2026). Not billing advice; verify sequencing rules for the encounter. All data sources