K95.01

Infection due to gastric band procedure

FY2027Chapter 11: Diseases of the digestive system/K90–K95 Other diseases of the digestive system

BillableComplete code, valid to report

K95.01 (also written K9501) is a billable ICD-10-CM diagnosis code for infection due to gastric band procedure. It is part of the FY2027 code set, effective October 1, 2026. It is one of the 4 codes in category K95 (Complications of bariatric procedures). The Alphabetic Index lists it under 1 entry. Its coding notes include a Use additional code instruction and 8 Excludes2 entries.

Use additional code

Add the listed code as a secondary code, if known.

This code
  • code to specify type of infection or organism, such as:

Excludes2

Not included here. Both codes may be reported if the patient has both conditions.

Also from chapter/block level (8 notes)
Inherited from Chapter 11 Diseases of the digestive system
  • certain conditions originating in the perinatal period (P04-P96)
  • certain infectious and parasitic diseases (A00-B99)
  • complications of pregnancy, childbirth and the puerperium (O00-O9A)
  • congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
  • endocrine, nutritional and metabolic diseases (E00-E88)
  • injury, poisoning and certain other consequences of external causes (S00-T88)
  • neoplasms (C00-D49)
  • symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)

Care settings

How CMS programs treat this code. These are CMS claim edits and list entries, not coverage or eligibility rules.

Home Health Primary

Accepted as the primary (principal) diagnosis on a home health claim. The Home Health Grouper assigns it to the MMTA - Gastrointestinal tract and Genitourinary system clinical group.

Source: CMS Home Health Grouper Software v07.2.26, effective October 1, 2026

Hospital CC

Counts as a complication or comorbidity (CC) when reported as a secondary diagnosis on an inpatient claim. It does not count when the principal diagnosis is one of the 70 codes in its exclusion list. Some MS-DRGs also ignore a CC or MCC that defines the DRG.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix C

HAC

On the CMS list of hospital-acquired conditions (HAC 11: Surgical Site Infection - Bariatric Surgery). When the claim reports it with a present-on-admission (POA) indicator of N (not present) or U (documentation insufficient), CMS does not pay the CC or MCC DRG for it. A POA of Y (present) or W (clinically undetermined) is paid normally. Some HAC categories also require a listed procedure.

Source: CMS MS-DRG Definitions Manual v44, effective October 1, 2026, Appendix I; CMS Hospital-Acquired Conditions (HAC) Coding page, POA indicator payment table

Alphabetic Index terms

Terms the official Alphabetic Index lists for this code. 1 entry