K86.0

K86.0: Alcohol-induced chronic pancreatitis

Billable / specific codeICD-10-CM

K86.0 is a billable, specific ICD-10-CM code for alcohol-induced chronic pancreatitis. It is valid for submission on a claim.

Check K86.0 with the rest of the claim: free scrubber

Excludes2: not included here, but may coexist

The excluded condition is not part of this code, but a patient can have both. You may code both.

alcohol induced acute pancreatitis (K85.2-)

Use additional code

Add a secondary code to capture the detail described below.

code to identify:
alcohol abuse and dependence (F10.-)

Code also

Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.

exocrine pancreatic insufficiency (K86.81)

Excludes2 inherited from the categories above K86.0

Not part of this code, but both may be coded when both are present.

Written on K86: Other diseases of pancreas

fibrocystic disease of pancreas (E84.-)
islet cell tumor (of pancreas) (D13.7)
pancreatic steatorrhea (K90.3)

Risk adjustment

K86.0 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 79 Chronic Pancreatitis0.357 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score. Look up the whole chart to see which of its HCCs the hierarchy would zero.

Medicare coverage

K86.0 is named in 12 Medicare coverage policies: 12 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56580Billing and Coding: Computerized Axial Tomography (CT), Thorax
A56841Billing and Coding: Vitamin D; 25 hydroxy, includes fraction(s), if performed