2025 ICD-10-CM code K85.00
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the digestive system - Disorders of gallbladder, biliary tract and pancreas Diseases of the digestive system Feed
Idiopathic acute pancreatitis without necrosis or infection.
Modifiers may be applicable depending on the circumstances of the encounter, such as the place of service or the type of procedure performed.Consult the current CPT and ICD-10-CM coding guidelines for more information regarding the use of modifiers with K85.00.
Medical necessity is established by the presence of clinical findings consistent with acute pancreatitis, such as severe abdominal pain, elevated pancreatic enzymes, and imaging findings supporting the diagnosis.The absence of necrosis or infection further supports the use of K85.00.Clinical judgment and detailed documentation are crucial.
Diagnosis and management of acute pancreatitis, including pain management, fluid resuscitation, nutritional support, and monitoring for complications.May involve consultations with gastroenterology and surgery.
In simple words: This code describes a sudden inflammation of the pancreas (a gland that helps digest food) where the exact reason is unknown and there's no tissue damage or infection. It causes a lot of belly pain.
K85.00 in the ICD-10-CM coding system signifies idiopathic acute pancreatitis without necrosis or infection.This code is used to classify cases of acute pancreatitis where the underlying cause is unknown and there is no evidence of tissue death (necrosis) or infection.The condition involves sudden inflammation of the pancreas, which can cause severe abdominal pain and other symptoms.This specific code excludes cases with complications such as necrosis or infection, which would be coded differently.
Example 1: A 45-year-old male presents with sudden onset of severe epigastric pain radiating to the back.Blood tests reveal elevated amylase and lipase levels.Imaging studies show mild pancreatic edema but no necrosis or abscess.K85.00 is assigned., A 30-year-old female is admitted to the ER with acute abdominal pain.Physical examination reveals tenderness in the epigastrium.Laboratory results show markedly elevated serum amylase and lipase.CT scan demonstrates mild pancreatitis without evidence of necrosis or infection.K85.00 is the appropriate code., A 60-year-old male with a history of gallstones experiences sudden onset of severe abdominal pain.Lab tests show elevated amylase and lipase, and imaging reveals mild inflammation but no gallstones obstructing the pancreatic duct.K85.00 is assigned after ruling out other causes.
Detailed history of present illness including onset, location, character, radiation, and aggravating/relieving factors of abdominal pain; results of physical exam, including abdominal tenderness; laboratory results (amylase, lipase, complete blood count, blood chemistry); and imaging findings (ultrasound, CT scan).
** Always review the most current ICD-10-CM guidelines for the most accurate coding practices.Accurate coding requires comprehensive clinical documentation.This information is for guidance only and should not be considered a substitute for professional medical coding advice.
- Payment Status: Active
- Specialties:Gastroenterology, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Emergency Room - Hospital