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K29.81 ICD-10-CM Code: Duodenitis with bleeding

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
2 Excludes1 · 1 Excludes2

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 377 — GASTROINTESTINAL HEMORRHAGE WITH MCC (MDC 06)
  • MS-DRG 378 — GASTROINTESTINAL HEMORRHAGE WITH CC (MDC 06)
  • MS-DRG 379 — GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC (MDC 06)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K29.81 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on K29.81 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Source: inherited from K29

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from K20-K31

Coder workflow for K29.81

MedCoder structured workflow — derived from this code’s own official record

Before you code K29.81

  1. K29.81’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).

    Guide: Combination codes →

  2. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with K29.81. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

    See the official tabular notes

Choose the right path

  1. Does the documentation support a condition named in K29.81’s Excludes1 note?
    Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
    No → Continue.

    ReviewK52.81, E16.4

Consider K29.81. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement
Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
The associated condition or complication
Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

Official instructions as workflow

  • Excludes1 — check before selecting K29.81(2 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with K29.81: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareK52.81, E16.4

    See the official tabular notes · Guidelines I.A.12.a

  • Excludes2 — not part of K29.81(1 note)

    Coding workflow: The conditions named in this note are not included in K29.81. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareK44

    See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: Both the condition K29.81 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewK52.81, E16.4

Documentation: Only one of the components this code’s title joins is documented.

Coding question: Is K29.81 supported?

Path: Review the code for the documented component on its own.

Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Code Overview

Duodenitis with bleeding is a billable ICD-10-CM diagnosis code (K29.81).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Verify Before Coding

  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name K29.81 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: K92.2 — Gastrointestinal hemorrhage, unspecified (via K29.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 21 Code First instructions: T36 — Poisoning by, adverse effect of and underdosing of systemic antibiotics (via K29.-), T36-T39 — Antibiotics & Anti-infectives (T36-T39) (via K29.-), T36-T50 — Poisoning by, adverse effects of and underdosing of drugs, medicaments and biological substances (T36-T50) (via K29.-), T37 — Poisoning by, adverse effect of and underdosing of other systemic anti-infectives and antiparasitics (via K29.-), T38 — Poisoning by, adverse effect of and underdosing of hormones and their synthetic substitutes and antagonists, not elsewhere classified (via K29.-), T39 — Poisoning by, adverse effect of and underdosing of nonopioid analgesics, antipyretics and antirheumatics (via K29.-), T40 — Poisoning by, adverse effect of and underdosing of narcotics and psychodysleptics [hallucinogens] (via K29.-), T40-T41 — Analgesics & Antipyretics (T40-T41) (via K29.-), T41 — Poisoning by, adverse effect of and underdosing of anesthetics and therapeutic gases (via K29.-), T42 — Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs (via K29.-), T42-T43 — Anticonvulsants & Psychotropics (T42-T43) (via K29.-), T43 — Poisoning by, adverse effect of and underdosing of psychotropic drugs, not elsewhere classified (via K29.-), T44 — Poisoning by, adverse effect of and underdosing of drugs primarily affecting the autonomic nervous system (via K29.-), T44-T46 — Cardiovascular & Gastrointestinal (T44-T46) (via K29.-), T45 — Poisoning by, adverse effect of and underdosing of primarily systemic and hematological agents, not elsewhere classified (via K29.-), T46 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the cardiovascular system (via K29.-), T47 — Poisoning by, adverse effect of and underdosing of agents primarily affecting the gastrointestinal system (via K29.-), T47-T50 — Hormones & Systemic Agents (T47-T50) (via K29.-), T48 — Poisoning by, adverse effect of and underdosing of agents primarily acting on smooth and skeletal muscles and the respiratory system (via K29.-), T49 — Poisoning by, adverse effect of and underdosing of topical agents primarily affecting skin and mucous membrane and by ophthalmological, otorhinorlaryngological and dental drugs (via K29.-), +1 more.

Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 72 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 377 (MDC 06), DRG 378 (MDC 06), DRG 379 (MDC 06).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG007 — Gastritis and duodenitis (default); DIG021 — Gastrointestinal hemorrhage.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

K28.6 — Chronic or unspecified gastrojejunal ulcer with both hemorrhage and perforation, K28.7 — Chronic gastrojejunal ulcer without hemorrhage or perforation, K28.9 — Gastrojejunal ulcer, unspecified as acute or chronic, without hemorrhage or perforation, K29.01 — Acute gastritis with bleeding, K29.21 — Alcoholic gastritis with bleeding, K29.31 — Chronic superficial gastritis with bleeding, K29.41 — Chronic atrophic gastritis with bleeding, K29.51 — Unspecified chronic gastritis with bleeding, K29.61 — Other gastritis with bleeding, K29.71 — Gastritis, unspecified, with bleeding, K29.91 — Gastroduodenitis, unspecified, with bleeding, K31.811 — Angiodysplasia of stomach and duodenum with bleeding, K55.21 — Angiodysplasia of colon with hemorrhage, K57.01 — Diverticulitis of small intestine with perforation and abscess with bleeding, K57.11 — Diverticulosis of small intestine without perforation or abscess with bleeding, K57.13 — Diverticulitis of small intestine without perforation or abscess with bleeding, K57.21 — Diverticulitis of large intestine with perforation and abscess with bleeding, K57.31 — Diverticulosis of large intestine without perforation or abscess with bleeding, K57.33 — Diverticulitis of large intestine without perforation or abscess with bleeding, K57.41 — Diverticulitis of both small and large intestine with perforation and abscess with bleeding, +51 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Gastritis and duodenitis, Gastrointestinal hemorrhage).

K29.31 — Chronic superficial gastritis with bleeding, K29.40 — Chronic atrophic gastritis without bleeding, K29.41 — Chronic atrophic gastritis with bleeding, K29.50 — Unspecified chronic gastritis without bleeding, K29.51 — Unspecified chronic gastritis with bleeding, K29.60 — Other gastritis without bleeding, K29.61 — Other gastritis with bleeding, K29.70 — Gastritis, unspecified, without bleeding, K29.71 — Gastritis, unspecified, with bleeding, K29.80 — Duodenitis without bleeding, K29.90 — Gastroduodenitis, unspecified, without bleeding, K29.91 — Gastroduodenitis, unspecified, with bleeding, K31.811 — Angiodysplasia of stomach and duodenum with bleeding, K31.82 — Dieulafoy lesion (hemorrhagic) of stomach and duodenum, K50.011 — Crohn's disease of small intestine with rectal bleeding, K50.111 — Crohn's disease of large intestine with rectal bleeding, K50.811 — Crohn's disease of both small and large intestine with rectal bleeding, K50.911 — Crohn's disease, unspecified, with rectal bleeding, K51.011 — Ulcerative (chronic) pancolitis with rectal bleeding, K51.211 — Ulcerative (chronic) proctitis with rectal bleeding, +50 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Inflammation, inflamed, inflammatory”; these codes share that main term but sit in a different category of the Tabular List.

J68.2 — Upper respiratory inflammation due to chemicals, gases, fumes and vapors, not elsewhere classified (respiratory, upper, due to, chemicals, gases, fumes or vapors), J70.0 — Acute pulmonary manifestations due to radiation (respiratory, upper, acute, due to radiation), J70.1 — Chronic and other pulmonary manifestations due to radiation (respiratory, upper, due to, radiation), J98.4 — Other disorders of lung (lung, chronic), J98.8 — Other specified respiratory disorders (chest), K05.10 — Chronic gingivitis, plaque induced (gum), K05.11 — Chronic gingivitis, non-plaque induced (gum, nonplaque induced), K12.1 — Other forms of stomatitis (mouth), K13.0 — Diseases of lips (lip), K14.0 — Glossitis (tongue), K51.40 — Inflammatory polyps of colon without complications (polyp, colon), K62.89 — Other specified diseases of anus and rectum (rectum), K73.9 — Chronic hepatitis, unspecified (liver, chronic), K75.0 — Abscess of liver (liver, suppurative), K91.850 — Pouchitis (ileoanalpouch), L08.82 — Omphalitis not of newborn (navel), L08.9 — Local infection of the skin and subcutaneous tissue, unspecified (skin), M13.169 — Monoarthritis, not elsewhere classified, unspecified knee (knee), M27.2 — Inflammatory conditions of jaws (jaw), M27.3 — Alveolitis of jaws (alveoli, teeth), +61 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Fecal Occult Blood Test (FOBT), Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of K29.81 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K29.81 with these 9 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

Referenced by Code First instructions (21)

Clinical classification (CCSR)

MS-DRG Grouper

MDC crossing

  • MDC 06 — Diseases and Disorders of the Digestive System[MDC crossing]: “Diseases and Disorders of the Digestive System — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 5,744 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

  • Duodenitis (nonspecific) (peptic), with bleeding[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Inflammation, inflamed, inflammatory (with exudation), duodenum, with bleeding[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (27)

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data
CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page
Inpatient payment groups Official source data
CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page
Change history and date-of-service validity Official source data
CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
Comparisons, relationships and the contextual map MedCoder structured relationship
Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
Summary and FAQ answers MedCoder explanation
Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Duodenitis with bleeding

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K29.81 in its code family, with their registry titles.

View all codes in the K29 family