Other diseases of pancreas
In Disorders of gallbladder, biliary tract and pancreas (K80-K87), chapter 11: Diseases of the Digestive System
7 billable codes under K86: 4 are a CC; 2 map to HCC 79 (Chronic Pancreatitis).A CC or MCC (major CC) is a secondary diagnosis that raises the MS-DRG payment. An HCC counts toward a Medicare Advantage patient's risk score.
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Instructional notes
Official coding guidelines
From the ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027 (CMS and NCHS). Links open the PDF at the right page.
There are no chapter-specific rules for Chapter 11 yet, so the general rules in Section I.B apply.
All codes under K86
K86 can't be used on a claim. Pick a billable code below; grey headings group them.
K86 MS-DRGs
As the principal diagnosis, the billable codes under K86 group to MS-DRG 438, 439, 440, 791, or 793 (v44.0). Which one applies depends on procedures performed, secondary diagnoses (CC/MCC), and the patient's age and discharge status.
- DRG 438 Disorders of Pancreas Except Malignancy with MCC (7 of 7 codes)
- DRG 439 Disorders of Pancreas Except Malignancy with CC (7 of 7 codes)
- DRG 440 Disorders of Pancreas Except Malignancy without CC/MCC (7 of 7 codes)
- DRG 791 Prematurity with Major Problems (2 of 7 codes)
- DRG 793 Full Term Neonate with Major Problems (2 of 7 codes)
Other codes that refer to K86
Notes on these codes point to K86.
- E08 Code First: pancreatitis and other diseases of the pancreas (K85-K86.-)
About the condition
Plain-language background from MedlinePlus (National Library of Medicine), not coding guidance.
Pancreatic Diseases
The pancreas is a gland behind your stomach and in front of your spine. It produces juices that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems. These include:
Read more about pancreatic diseases on MedlinePlusCode history
Valid since FY2016, when ICD-10-CM took effect on October 1, 2015. No changes since.