2025 ICD-10-CM code K85.8
Other acute pancreatitis. This code encompasses cases of acute pancreatitis that are not attributed to specific causes like alcohol, drugs, or biliary conditions.
Medical necessity for the treatment of acute pancreatitis is established by the presence of characteristic symptoms, laboratory abnormalities, and imaging findings. The medical record must clearly document the severity of the condition and the need for interventions such as pain management, fluid resuscitation, and nutritional support.
Clinicians responsible for diagnosing and managing K85.8 should perform a thorough evaluation to identify the underlying cause, even if it falls outside the common categories. This may involve imaging studies, laboratory tests, and specialist consultations.Treatment focuses on supportive care, including pain management, fluid resuscitation, and nutritional support.
In simple words: This code is used when a person has sudden inflammation of the pancreas, but the cause is something other than gallstones, alcohol, or medications.
Other acute pancreatitis includes cases where the underlying cause is not identified or falls outside the categories of biliary, alcohol-induced, or drug-induced pancreatitis.It encompasses a range of etiologies such as hypertriglyceridemia, trauma, autoimmune pancreatitis, infections (other than those causing infected necrosis), and post-ERCP pancreatitis.
Example 1: A patient presents with acute abdominal pain, elevated amylase and lipase levels, and imaging findings consistent with pancreatitis.No evidence of gallstones, alcohol abuse, or recent medication use is found.After further investigation reveals hypertriglyceridemia as the likely cause, K85.8 is assigned., A patient develops acute pancreatitis following an endoscopic retrograde cholangiopancreatography (ERCP) procedure. Since the pancreatitis is a direct result of the procedure, K85.8 is used., A patient with known autoimmune disease develops acute pancreatitis.Further testing confirms autoimmune pancreatitis.As this is not categorized under other specific types, K85.8 is assigned.
Documentation should include the patient's presenting symptoms, laboratory results (amylase, lipase, etc.), imaging findings, and any procedures performed.Efforts to determine the etiology should be documented, even if a definitive cause is not identified. If necrosis or infection is present, it should be clearly documented.
** It is important to distinguish K85.8 from other, more specific forms of acute pancreatitis when possible.Thorough documentation is essential for accurate coding and appropriate reimbursement.
- Payment Status: Active
- Specialties:Gastroenterology, General surgery, Internal medicine
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Outpatient Hospital