Billing codes · ICD-10-CM code

K90.0 celiac disease on nutrition claims

By Javier Alvarez · Updated September 28, 2026 · 4 min read

Celiac disease is one of the clearest cases for medical nutrition therapy: the diet is the treatment. That makes K90.0 a strong diagnosis on a claim, as long as it's the right code for what the provider actually diagnosed, and the plan covers GI conditions under the member's nutrition benefit.

What K90.0 includes

K90.0, celiac disease, sits in category K90, intestinal malabsorption. Its inclusion terms:

• Celiac disease with steatorrhea
• Celiac gluten-sensitive enteropathy
• Nontropical sprue

Two instructional notes travel with it:

• Use additional code for associated disorders, including dermatitis herpetiformis (L13.0) and gluten ataxia (G32.81).
• Code also exocrine pancreatic insufficiency (K86.81) when the provider documents it.

The K90 category excludes intestinal malabsorption following GI surgery (K91.2). Malabsorption after bariatric surgery is not celiac disease, even when the diet looks similar.

K90.0 didn't change in the FY2027 update effective October 1, 2026.

Celiac vs. gluten sensitivity vs. wheat allergy

Referrals use these words loosely. The codes don't:

The last row matters. Section IV.H of the Official Guidelines says outpatient claims don't code diagnoses documented as "probable," "suspected," "rule out" or similar. A patient sent to you during a celiac workup is coded from the symptoms or findings on the referral (diarrhea, weight loss, iron deficiency anemia), not K90.0.

Coverage for celiac MNT

• Commercial plans usually treat celiac MNT as medical, not preventive. Aetna's CPB 0049 lists gastrointestinal disorders among the chronic disease states where nutritional counseling is medically necessary. Other plans have their own lists, visit caps and referral requirements. Verify before the first visit.
• Preventive benefits don't fit. Preventive MNT rows (such as UnitedHealthcare's) are built around cardiovascular risk, weight and prediabetes, so a K90.0 visit shouldn't be quoted to the patient as $0 preventive care.
• Medicare covers MNT for diabetes and renal disease only (NCD 180.1). A beneficiary with celiac disease and type 1 diabetes qualifies through the diabetes diagnosis, with a physician referral. Celiac disease alone doesn't.
• Medicaid varies by state.

For how GI niches compare on reimbursement, see best nutrition niches for reimbursement. Aetna's rules are summarized in Aetna nutrition counseling coverage.

Secondary codes worth adding

Section I.B.5 of the guidelines says signs and symptoms routinely associated with a disease aren't coded separately. Diarrhea, bloating or steatorrhea in a documented celiac patient don't need their own codes. Conditions that aren't an integral part of celiac disease do, when the provider documents them:

• Iron deficiency anemia. The index sends nutritional anemia with poor iron absorption to D50.8; otherwise D50.9. See D50.9 iron deficiency anemia.
• Vitamin D deficiency (E55.9) and other documented deficiencies.
• Dermatitis herpetiformis (L13.0), per the use-additional note.
• Coexisting GI diagnoses: IBS (K58) or GERD (K21.9) when separately documented.
• Type 1 diabetes, which often coexists and changes Medicare eligibility.

Example claim lines (invented)

What the note should show

• The provider's celiac diagnosis and how it was established (from the referral or chart), or the symptoms if the workup is still open.
• Current diet, sources of gluten exposure, label reading, and cross-contact risks you addressed.
• Relevant labs as reported (for example, ferritin or vitamin D) and growth or weight trend.
• Nutrition diagnosis in PES format, the intervention, follow-up plan, and face-to-face minutes for units.

Denials and fixes

For the rest of the diagnosis codes on nutrition claims, see the ICD-10 codes for dietitians reference.