2025 ICD-10-CM code K86.0
(Active) Effective Date: N/A Revision Date: N/A Digestive System Disorders - Other diseases of pancreas Diseases of the digestive system Feed
Alcohol-induced chronic pancreatitis.
Modifiers may apply depending on the circumstances of the encounter and the services provided.
Medical necessity is established by the presence of persistent symptoms of chronic pancreatitis (e.g., abdominal pain, weight loss, steatorrhea) confirmed by appropriate diagnostic testing.A history of significant alcohol consumption is crucial for coding K86.0.
Diagnosis and management of chronic pancreatitis, including assessment of alcohol use history, imaging studies (e.g., CT scan, MRI), laboratory tests (e.g., amylase, lipase, fecal fat), and management of associated complications (e.g., pain, malabsorption, diabetes).
In simple words: This code is for chronic pancreatitis caused by long-term heavy alcohol use.It's a long-lasting inflammation of the pancreas that can cause digestive problems and diabetes.
Alcohol-induced chronic pancreatitis is a chronic inflammatory condition of the pancreas primarily caused by long-term alcohol abuse.It's characterized by persistent inflammation, fibrosis, and potential exocrine and endocrine pancreatic insufficiency.The diagnosis requires a history of significant alcohol consumption and clinical findings consistent with chronic pancreatitis (e.g., persistent abdominal pain, steatorrhea, diabetes).Additional codes may be necessary to specify alcohol abuse or dependence (F10.-) and exocrine pancreatic insufficiency (K86.81).
Example 1: A 55-year-old male with a 20-year history of heavy alcohol consumption presents with persistent epigastric pain, weight loss, and steatorrhea.Imaging studies reveal chronic pancreatitis. K86.0 is coded along with F10.2 (Alcohol dependence)., A 60-year-old female with a history of alcohol abuse and chronic pancreatitis is admitted for exacerbation of abdominal pain.She also has diabetes mellitus.The code K86.0 is used, along with a code for diabetes and potentially F10.2 (Alcohol dependence)., A 48-year-old male with a history of alcohol use disorder is diagnosed with chronic pancreatitis. The patient reports consistent, dull epigastric pain and weight loss.K86.0 is coded along with a code for exocrine pancreatic insufficiency (K86.81).
Detailed history of alcohol consumption, including frequency, quantity, and duration.Results of laboratory tests (amylase, lipase, fecal fat).Imaging studies (CT scan, MRI, or endoscopic retrograde cholangiopancreatography (ERCP)) showing chronic changes in the pancreas.Documentation of symptoms (abdominal pain, weight loss, steatorrhea, diabetes).
** The accuracy of K86.0 relies heavily on a confirmed history of significant alcohol consumption.The code's use is increasingly questioned due to the multifactorial etiology of chronic pancreatitis.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Specialties:Gastroenterology, Hepatology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office