K86.1: Other chronic pancreatitis
K86.1 is a billable, specific ICD-10-CM code for other chronic pancreatitis. It is valid for submission on a claim.
Check K86.1 with the rest of the claim: free scrubberCode also
Both codes may be needed to describe the encounter fully. Sequencing depends on the reason for the visit.
- exocrine pancreatic insufficiency (K86.81)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Chronic pancreatitis NOS
- Infectious chronic pancreatitis
- Recurrent chronic pancreatitis
- Relapsing chronic pancreatitis
Risk adjustment
K86.1 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
K86.1 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
Alphabetic index entries that lead here
- Pancreatitis›chronic(infectious)
- Pancreatitis›cystic(chronic)
- Pancreatitis›fibrous(chronic)
- Pancreatitis›interstitial(chronic)
- Pancreatitis›relapsing, chronic
- Hypertension, hypertensive›pancreatic duct - code to underlying condition›with chronic pancreatitis
- Pancreatitis›chronic›recurrent
- Pancreatitis›chronic›relapsing
- Pancreatitis›recurrent›chronic
Code history
Unchanged in every release from FY2024 to FY2027.