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.
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)
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.
Medicare coverage
K86.1 is named in 12 Medicare coverage policies — 12 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- 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
How K86.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K86.1.
- 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
Related codes at this level
Codes that share K86. If K86.1 is not quite right, the correct code is usually one of these.
Questions about K86.1
- Is K86.1 a billable ICD-10-CM code?
- Yes. K86.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K86.1 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Disorders of gallbladder, biliary tract and pancreas (K80-K87).