2025 ICD-10-CM code K94.03
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Other complications of colostomy Diseases of the digestive system (K00-K95) Feed
Colostomy malfunction; a mechanical complication of a colostomy.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for treatment of a colostomy malfunction is established by the presence of symptoms impacting the patient's health and well-being.This might include abdominal pain, distension, infection, leakage, and bleeding. Documentation must clearly support the need for intervention.
The clinical responsibility for managing a colostomy malfunction falls on the surgeon or gastroenterologist. This includes diagnosing the cause of the malfunction, managing any complications, and possibly performing corrective surgery or procedures.
In simple words: This code describes a problem with a colostomy, a surgery that creates an opening in the large intestine to allow waste to pass out of the body.The problem could be a blockage, leakage, or other issue that prevents it from working correctly.
K94.03, Colostomy malfunction, is an ICD-10-CM code that classifies a mechanical issue with a colostomy.This encompasses various problems hindering the proper function of the surgically created opening in the colon, such as obstruction, leakage, prolapse, stenosis, or other mechanical failures.Accurate documentation should specify the nature of the malfunction.
Example 1: A patient presents with abdominal pain and distension, three days post-colostomy surgery.Examination reveals a complete obstruction of the colostomy. The physician documents the findings and codes K94.03 for the colostomy malfunction., A patient with a long-standing colostomy reports increasing leakage around the stoma site. The physician assesses the stoma and finds a partial prolapse and inflammation. K94.03 is used to describe the malfunctioning colostomy., A patient experiences severe bleeding from their colostomy.After examination and diagnostic testing, the physician diagnoses a colostomy hemorrhage (K94.01) secondary to a malfunction (K94.03).Both codes are used in this instance.
Complete medical record documentation should include a detailed description of the colostomy malfunction, including its nature, onset, symptoms, and severity.Relevant findings from physical examination, imaging studies (if performed), and laboratory results should also be included. The physician’s assessment of the condition, treatment plan, and response to treatment should be thoroughly documented.
** Accurate coding requires specific documentation of the type of colostomy malfunction.Unspecified complications should be coded as K94.00.This code should only be used when a mechanical problem with the colostomy is identified, not for functional issues or other complications.
- Revenue Code: Revenue codes will vary depending on the specific services rendered and payer requirements.
- RVU: RVUs are not directly associated with ICD-10 codes.Reimbursement is determined by the procedures and services performed, coded with CPT or HCPCS codes, which then have assigned RVUs.
- Global Days : Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule : Not applicable to ICD-10 codes.
- Specialties:General surgery, colorectal surgery, gastroenterology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center