ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesK64.9

K64.9

Billable

Unspecified hemorrhoids

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K64.9 is a billable code used to indicate a diagnosis of unspecified hemorrhoids.

Key Diagnostic Point:

Unspecified hemorrhoids, classified under ICD-10 code K64.9, refer to the presence of hemorrhoids without specific details regarding their type or severity. Hemorrhoids are swollen veins in the lower rectum and anus, akin to varicose veins. They can be classified as either internal or external, with internal hemorrhoids occurring inside the rectum and external hemorrhoids developing under the skin around the anus. Clinical presentation often includes symptoms such as rectal bleeding, discomfort, itching, and swelling. The disease progression can vary; while some patients may experience mild symptoms that resolve spontaneously, others may develop more severe complications, such as thrombosis or infection. Diagnostic considerations include a thorough patient history, physical examination, and possibly a digital rectal exam or anoscopy to rule out other conditions. The unspecified nature of K64.9 indicates that further details about the hemorrhoids are not documented, which may limit treatment options and clinical understanding.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Moderate, as the diagnosis may require differentiation from other anorectal conditions.
  • Treatment complexity: Moderate, as treatment can range from conservative management to surgical intervention depending on severity.
  • Documentation requirements: Moderate, as detailed documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Medium, as K64.9 lacks specificity regarding the type and severity of hemorrhoids.

Audit Risk Factors

  • Common coding errors: Misclassification of hemorrhoid types or failure to document severity.
  • Documentation gaps: Incomplete patient history or lack of supportive clinical findings.
  • Billing challenges: Potential for claim denials due to insufficient documentation or lack of specificity.

Specialty Focus

Medical Specialties

Primary medical specialty: Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Secondary specialty: Colorectal Surgery

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K64.9 lies in its prevalence among the adult population, with a substantial impact on quality of life due to associated discomfort and complications. Hemorrhoids are a common condition, affecting a significant portion of the population, particularly those aged 45 and older. Understanding the epidemiology of this condition can aid in population health management and resource allocation. Effective management of hemorrhoids can reduce healthcare utilization patterns, including emergency visits and surgical interventions, thereby improving overall patient outcomes.

ICD-9 vs ICD-10

The clinical significance of K64.9 lies in its prevalence among the adult population, with a substantial impact on quality of life due to associated discomfort and complications. Hemorrhoids are a common condition, affecting a significant portion of the population, particularly those aged 45 and older. Understanding the epidemiology of this condition can aid in population health management and resource allocation. Effective management of hemorrhoids can reduce healthcare utilization patterns, including emergency visits and surgical interventions, thereby improving overall patient outcomes.

Reimbursement & Billing Impact

reimbursement considerations, as some insurers may require more detailed coding to approve claims. Best practices include thorough documentation of symptoms, treatment plans, and any follow-up care provided.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K64.9?

K64.9 covers unspecified hemorrhoids, which may include internal or external hemorrhoids without further classification. It does not specify the presence of complications such as thrombosis or prolapse.

When should K64.9 be used instead of related codes?

K64.9 should be used when the type or severity of hemorrhoids is not documented. If specific details are available, such as thrombosed or prolapsed hemorrhoids, the more specific codes (K64.1 or K64.0) should be utilized.

What documentation supports K64.9?

Documentation should include a thorough patient history, physical examination findings, and any relevant diagnostic tests. It is essential to note the absence of specific details regarding the hemorrhoids to justify the use of K64.9.