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K91.86 ICD-10-CM Code: Retained cholelithiasis following cholecystectomy

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

Coding at a Glance

Tabular directives
7 Excludes2

Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.

What you need to know

Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.

Excludes2Not included here; may be reported together
  • complications of artificial opening of digestive system (K94.-)
  • complications of bariatric procedures (K95.-)
  • gastrojejunal ulcer (K28.-)
  • postprocedural (radiation) retroperitoneal abscess (K68.11)

+3 more in Instructions

Most relevant related codes MedCoder-derived

Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.

CompareCheck ClaimView Related Codes

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 v44, Appendix B.

  • MS-DRG 393 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC (MDC 06)
  • MS-DRG 394 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC (MDC 06)
  • MS-DRG 395 — OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC (MDC 06)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

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 K91.86 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026

Trace:FY2027 changesChange historyRelease, file and checksum

Notes without a marker are published on K91.86 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

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

Source: inherited from K91

Coder workflow for K91.86

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

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).

Official instructions as workflow

  • Excludes2 — not part of K91.86(7 notes)

    Coding workflow: The conditions named in this note are not included in K91.86. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareK94, K95, K28, K68.11, K52.0, K62.7

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

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.

Don’t confuse K91.86 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K91.86 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • K94— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of complications of artificial opening of digestive system adds K94; it is not part of this code and both may be reported when both are documented.

    Full comparison: K91.86 vs K94 →

  • K95— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of complications of bariatric procedures adds K95; it is not part of this code and both may be reported when both are documented.

    Full comparison: K91.86 vs K95 →

  • K28— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of gastrojejunal ulcer adds K28; it is not part of this code and both may be reported when both are documented.

    Full comparison: K91.86 vs K28 →

  • K68.11— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of postprocedural (radiation) retroperitoneal abscess adds K68.11; it is not part of this code and both may be reported when both are documented.

    Full comparison: K91.86 vs K68.11 →

  • K52.0— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of radiation colitis adds K52.0; it is not part of this code and both may be reported when both are documented.

    Full comparison: K91.86 vs K52.0 →

  • K62.7— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of radiation proctitis adds K62.7; it is not part of this code and both may be reported when both are documented.

    Full comparison: K91.86 vs K62.7 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Coding context

Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.

Code Overview

Retained cholelithiasis following cholecystectomy is a billable ICD-10-CM diagnosis code (K91.86).

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

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

  • CC as a secondary diagnosis (FY2027). 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-derived relationships — computed from published CMS and AHRQ datasets

Other codes that name K91.86 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: K80 — Cholelithiasis.

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

Referenced by 1 Excludes2 note: T81 — Complications of procedures, not elsewhere classified (via K91.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

MS-DRG Grouper Relationships (FY2027)

Potential MS-DRG participation — not a DRG assignment.

FY2027 MS-DRG: CC — 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 70 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 393 (MDC 06), DRG 394 (MDC 06), DRG 395 (MDC 06), DRG 791 (MDC 15), DRG 793 (MDC 15).

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

Clinical classification (AHRQ CCSR):DIG024 — Postprocedural or postoperative digestive system complication (default).

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 CC — 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.

H95.813 — Postprocedural stenosis of external ear canal, bilateral, H95.819 — Postprocedural stenosis of unspecified external ear canal, H95.88 — Other intraoperative complications and disorders of the ear and mastoid process, not elsewhere classified, H95.89 — Other postprocedural complications and disorders of the ear and mastoid process, not elsewhere classified, I97.3 — Postprocedural hypertension, K91.81 — Other intraoperative complications of digestive system, K91.82 — Postprocedural hepatic failure, K91.83 — Postprocedural hepatorenal syndrome, K91.850 — Pouchitis, K91.858 — Other complications of intestinal pouch, K91.89 — Other postprocedural complications and disorders of digestive system, K94.20 — Gastrostomy complication, unspecified, K94.21 — Gastrostomy hemorrhage, K94.22 — Gastrostomy infection, K94.23 — Gastrostomy malfunction, K94.29 — Other complications of gastrostomy, K94.30 — Esophagostomy complications, unspecified, K94.31 — Esophagostomy hemorrhage, K94.32 — Esophagostomy infection, K94.33 — Esophagostomy malfunction, +49 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Postprocedural or postoperative digestive system complication).

K91.62 — Intraoperative hemorrhage and hematoma of a digestive system organ or structure complicating other procedure, K91.71 — Accidental puncture and laceration of a digestive system organ or structure during a digestive system procedure, K91.72 — Accidental puncture and laceration of a digestive system organ or structure during other procedure, K91.81 — Other intraoperative complications of digestive system, K91.82 — Postprocedural hepatic failure, K91.83 — Postprocedural hepatorenal syndrome, K91.840 — Postprocedural hemorrhage of a digestive system organ or structure following a digestive system procedure, K91.841 — Postprocedural hemorrhage of a digestive system organ or structure following other procedure, K91.850 — Pouchitis, K91.858 — Other complications of intestinal pouch, K91.870 — Postprocedural hematoma of a digestive system organ or structure following a digestive system procedure, K91.871 — Postprocedural hematoma of a digestive system organ or structure following other procedure, K91.872 — Postprocedural seroma of a digestive system organ or structure following a digestive system procedure, K91.873 — Postprocedural seroma of a digestive system organ or structure following other procedure, K91.89 — Other postprocedural complications and disorders of digestive system, K94.00 — Colostomy complication, unspecified, K94.01 — Colostomy hemorrhage, K94.02 — Colostomy infection, K94.03 — Colostomy malfunction, K94.09 — Other complications of colostomy, +28 more

Same Index main term, other category

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

E87.29 — Other acidosis (carbon dioxide), F45.8 — Other somatoform disorders (urine, psychogenic), K00.6 — Disturbances in tooth eruption (deciduous tooth), K08.3 — Retained dental root (dental root), K31.89 — Other diseases of stomach and duodenum (gastric), N90.89 — Other specified noninflammatory disorders of vulva and perineum (smegma, clitoris), N94.89 — Other specified conditions associated with female genital organs and menstrual cycle (menses), N99.83 — Residual ovary syndrome (ovary syndrome), O02.0 — Blighted ovum and nonhydatidiform mole (dead, ovum), O02.1 — Missed abortion (fetus, dead, early), O36.4 — Maternal care for intrauterine death (dead, fetus), O72.0 — Third-stage hemorrhage (placenta), O72.2 — Delayed and secondary postpartum hemorrhage (decidua), O73.0 — Retained placenta without hemorrhage (placenta, without hemorrhage), O73.1 — Retained portions of placenta and membranes, without hemorrhage (decidua, without hemorrhage), O92.79 — Other disorders of lactation (milk), R33.0 — Drug induced retention of urine (urine, drug-induced), R33.8 — Other retention of urine (urine, organic), R33.9 — Retention of urine, unspecified (urine), R39.2 — Extrarenal uremia (nitrogen, extrarenal), +15 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.

Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of K91.86 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 K91.86 with these 2 related codes in Claim Check

Hierarchy

Referenced by Excludes1 notes

  • K80 — Cholelithiasis[Excludes1]: “retained cholelithiasis following cholecystectomy (K91.86)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

Referenced by Excludes2 notes

  • T81 — Complications of procedures, not elsewhere classified[Excludes2](via K91.-): “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.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027

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. 5,748 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period[MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — 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.”— CMS MS-DRG Definitions Manual · FY2027

Index entries

  • Retained, cholelithiasis following cholecystectomy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Retained, gallstones, following cholecystectomy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Retention, cholelithiasis following cholecystectomy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
  • Retention, gallstones, following cholecystectomy[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes (31)

Change history

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

Reference

Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.

Indexed Clinical Terms (4)

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.

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 FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
Coding guidelines Official source data
ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 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 — v44 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-derived 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 editorial 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.

Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources

Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "K91.86 — Retained cholelithiasis following cholecystectomy." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k91.86-retained-cholelithiasis-following-cholecystectomy

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Retained cholelithiasis following cholecystectomy

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, 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 K91.86 in its code family, with their registry titles.

View all codes in the K91 family