2025 ICD-10-CM code K85
Acute inflammation of the pancreas.
Medical necessity for the treatment of acute pancreatitis is established by the presence of signs, symptoms, and laboratory/imaging findings consistent with the diagnosis. Treatment is necessary to manage pain, prevent complications (such as infection, organ failure, and pseudocysts), and address the underlying cause.
Physicians diagnosing and managing acute pancreatitis have the responsibility to accurately document the patient’s presenting symptoms, history,physical exam findings, and diagnostic test results. They must determine the underlying cause if possible and implement appropriate treatment strategies, such as pain management, fluid resuscitation, and nutritional support. Additionally, they should monitor the patient for complications and consult with specialists like gastroenterologists or surgeons when necessary.
- Diseases of the digestive system (K00-K95)
- Disorders of gallbladder, biliary tract and pancreas (K80-K87)
In simple words: Acute pancreatitis is a sudden and severe inflammation of the pancreas. It can cause intense abdominal pain, along with other symptoms like nausea, vomiting, fever, and sometimes even shock.Common causes include excessive alcohol use, gallstones blocking the pancreatic duct, physical injury, and certain medications.
An acute inflammatory process of the pancreas, potentially leading to necrosis of the pancreatic parenchyma.Common signs and symptoms include severe abdominal pain, nausea, vomiting, diarrhea, fever, and shock. Various factors can cause acute pancreatitis, such as alcohol consumption, gallstones, trauma, and certain medications.
Example 1: A 45-year-old male presents to the emergency room with severe epigastric pain radiating to his back, nausea, and vomiting.His laboratory results reveal elevated amylase and lipase levels. He has a history of gallstones. The physician diagnoses him with acute biliary pancreatitis (K85.1)., A 60-year-old female with a history of chronic alcohol abuse is admitted to the hospital with persistent abdominal pain, fever, and an elevated white blood cell count.Imaging studies show pancreatic inflammation.The physician diagnoses her with alcohol-induced acute pancreatitis (K85.2)., A 30-year-old female develops acute pancreatitis after starting a new medication. Her symptoms improve after discontinuing the drug, and the physician diagnoses her with drug-induced acute pancreatitis (K85.3).
Documentation for acute pancreatitis should include details of the patient's presenting symptoms (e.g., abdominal pain, nausea, vomiting), relevant medical history (e.g., alcohol use, gallstones, medications), physical examination findings, laboratory results (amylase, lipase, blood cell counts, etc.), and imaging studies (ultrasound, CT scan, MRI).The documentation should also support the specific cause of the pancreatitis if determined.
** For outpatient coding, append a diagnostic confidence indicator (A, G, V, or Z) to the ICD-10-CM code.
- Payment Status: Active
- Specialties:Gastroenterology, Internal Medicine, Emergency Medicine, General Surgery
- Place of Service:Inpatient Hospital, Emergency Room - Hospital, Office