K55.30: Necrotizing enterocolitis, unspecified

K55.30, necrotizing enterocolitis, unspecified, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 22 HCPCS Level II codes, including G0105 (Colorectal cancer screening; colonoscopy on individual at…), G9998 (Documentation of medical reason(s) for an interval of less…), G9999 (Documentation of system reason(s) for an interval of less…). The articles come from 1 Medicare contractor. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.

HCPCS Level II codes with K55.30 as a covered diagnosis

CodeDescriptionMedicare coverageDMEPOS fee 2026 (state range)Articles listing it
G0105Colorectal cancer screening; colonoscopy on individual at high riskSpecial coverage instructions apply—1
G9998Documentation of medical reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., last colonoscopy incomplete, last colonoscopy had inadequate prep, piecemeal removal of adenomas, or sessile serrated polyps >= 20 mm in size, last colonoscopy found greater than 10 adenomas, lower gastrointestinal bleeding, or patient at high risk for colon cancer due to underlying medical history ([i.e. crohn's disease, ulcerative colitis, personal or family history of colon cancer, hereditary colorectal cancer syndromes])Carrier judgment—1
G9999Documentation of system reason(s) for an interval of less than 3 years since the last colonoscopy (e.g., unable to locate previous colonoscopy report, patient cannot provide precise date or details from previous colonoscopy, previous colonoscopy report was incomplete)Carrier judgment—1
J0585Injection, onabotulinumtoxina, 1 unitSpecial coverage instructions apply—1
C8900Magnetic resonance angiography with contrast, abdomenSpecial coverage instructions apply—1
C8901Magnetic resonance angiography without contrast, abdomenSpecial coverage instructions apply—1
C8902Magnetic resonance angiography without contrast followed by with contrast, abdomenSpecial coverage instructions apply—1
C8909Magnetic resonance angiography with contrast, chest (excluding myocardium)Special coverage instructions apply—1
C8910Magnetic resonance angiography without contrast, chest (excluding myocardium)Special coverage instructions apply—1
C8911Magnetic resonance angiography without contrast followed by with contrast, chest (excluding myocardium)Special coverage instructions apply—1
C8912Magnetic resonance angiography with contrast, lower extremitySpecial coverage instructions apply—1
C8913Magnetic resonance angiography without contrast, lower extremitySpecial coverage instructions apply—1
C8914Magnetic resonance angiography without contrast followed by with contrast, lower extremitySpecial coverage instructions apply—1
C8918Magnetic resonance angiography with contrast, pelvisSpecial coverage instructions apply—1
C8919Magnetic resonance angiography without contrast, pelvisSpecial coverage instructions apply—1
C8920Magnetic resonance angiography without contrast followed by with contrast, pelvisSpecial coverage instructions apply—1
C8931Magnetic resonance angiography with contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8932Magnetic resonance angiography without contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8933Magnetic resonance angiography without contrast followed by with contrast, spinal canal and contentsSpecial coverage instructions apply—1
C8934Magnetic resonance angiography with contrast, upper extremitySpecial coverage instructions apply—1
C8935Magnetic resonance angiography without contrast, upper extremitySpecial coverage instructions apply—1
C8936Magnetic resonance angiography without contrast followed by with contrast, upper extremitySpecial coverage instructions apply—1

Medicare policy articles listing K55.30

A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.

Other K55 diagnoses (Vascular disorders of intestine)

Frequently asked questions

Does Medicare cover K55.30 (Necrotizing enterocolitis, unspecified)?

Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list K55.30 as a covered diagnosis for 22 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.

Which HCPCS codes can be billed with ICD-10 K55.30?

The Level II codes from the policies most specific to this diagnosis are G0105 (Colorectal cancer screening; colonoscopy on individual at…, 1 article); G9998 (Documentation of medical reason(s) for an interval of less…, 1 article); G9999 (Documentation of system reason(s) for an interval of less…, 1 article); J0585 (Injection, onabotulinumtoxina, 1 unit, 1 article); C8900 (Magnetic resonance angiography with contrast, abdomen, 1 article). Code choice depends on the item supplied; check each code's descriptor.

Which Medicare policy articles list K55.30?

A56632 (Billing and Coding: Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy); A56389 (Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization); A56775 (Billing and Coding: Magnetic Resonance Angiography).

What is ICD-10-CM code K55.30?

K55.30 is the ICD-10-CM code for necrotizing enterocolitis, unspecified, in category K55 (Vascular disorders of intestine), chapter 11: Diseases of the digestive system.

Next steps

Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.

Chapter 11: Diseases of the digestive system · All diagnoses · HCPCS lookup