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2025 ICD-10-CM code K85.0

Idiopathic acute pancreatitis.

Appropriate coding requires consideration of the presence or absence of complications such as necrosis and infection.Additional codes may be needed for complications such as organ failure or infection.

Modifiers may apply depending on the specific circumstances of the encounter (e.g., place of service, anesthesia, significant complications).

Medical necessity for the diagnosis and treatment of acute pancreatitis is established by the presence of clinical symptoms and laboratory/imaging findings consistent with the diagnosis.The severity of the pancreatitis determines the level of intervention required (e.g., supportive care vs. surgical intervention).

Diagnosis and management of acute pancreatitis, including pain management, supportive care (fluid resuscitation, nutritional support), and treatment of complications such as infection or necrosis.May involve consultation with gastroenterology or surgery.

IMPORTANT:K85.00: Idiopathic acute pancreatitis without necrosis or infection; K85.01: Idiopathic acute pancreatitis with uninfected necrosis; K85.02: Idiopathic acute pancreatitis with infected necrosis.Other codes within the K85 range specify pancreatitis with other etiologies (e.g., biliary, alcohol-induced, drug-induced).

In simple words: Idiopathic acute pancreatitis is a sudden inflammation of the pancreas for which the cause is unknown.It can be mild or severe, sometimes leading to tissue damage and infection.

Idiopathic acute pancreatitis refers to acute inflammation of the pancreas without an identifiable cause.This can range from mild cases to severe ones involving necrosis (tissue death) and infection.

Example 1: A 45-year-old female presents to the emergency department with severe epigastric pain radiating to the back, nausea, vomiting, and fever.Labs reveal elevated amylase and lipase levels.Imaging shows acute pancreatitis without necrosis or infection.The diagnosis is idiopathic acute pancreatitis (K85.0)., A 60-year-old male with a history of alcohol abuse is admitted with acute pancreatitis.CT scan reveals areas of necrosis.The diagnosis is idiopathic acute pancreatitis with uninfected necrosis (K85.01).He requires intensive care and likely surgical debridement., A 30-year-old female develops acute pancreatitis post-cholecystectomy.However, there is no evidence of gallstones or other biliary etiology.Despite extensive investigation, no cause is identified.The diagnosis remains idiopathic acute pancreatitis (K85.0).

* Detailed history including risk factors (alcohol use, gallstones, medications, family history).* Physical examination noting abdominal tenderness and vital signs.* Laboratory findings (amylase, lipase, complete blood count, blood chemistry).* Imaging studies (abdominal CT scan, MRI).* Documentation of any complications (necrosis, infection, organ failure).* Treatment plan and response to treatment.

** Idiopathic acute pancreatitis is a diagnosis of exclusion, meaning other causes of pancreatitis must be ruled out before this diagnosis is applied.The severity of the disease and the presence of complications will influence the treatment and prognosis.

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