2025 ICD-10-CM code K86.81
(Active) Effective Date: N/A Revision Date: N/A Diseases of the digestive system - Other diseases of pancreas Diseases of the digestive system Feed
Exocrine pancreatic insufficiency.
No specific modifiers are directly associated with K86.81; however, modifiers may be needed if the condition is related to another procedure or service.
Medical necessity for coding K86.81 is established through documentation of clinical findings consistent with exocrine pancreatic insufficiency (e.g., steatorrhea, weight loss, malabsorption) and confirmation through appropriate diagnostic testing.The treatment plan should address the symptoms and improve nutrient absorption.
Gastroenterologists, endocrinologists, and other specialists may be involved in the diagnosis and management of exocrine pancreatic insufficiency.
In simple words: Your pancreas doesn't make enough enzymes to digest your food properly, causing problems like diarrhea, weight loss, and greasy stools.
Exocrine pancreatic insufficiency (EPI) is a condition where the pancreas doesn't produce enough digestive enzymes. These enzymes are crucial for breaking down food, especially fats, proteins, and carbohydrates.The insufficient enzyme production leads to malabsorption of nutrients, resulting in various symptoms like diarrhea, weight loss, and steatorrhea (fatty stools).
Example 1: A patient with cystic fibrosis presents with chronic diarrhea, weight loss, and fatty stools.Laboratory tests confirm exocrine pancreatic insufficiency. K86.81 is coded to reflect this diagnosis., A patient with a history of chronic pancreatitis experiences worsening malabsorption symptoms, including steatorrhea and weight loss.Further evaluation confirms EPI. K86.81 is added to the patient's diagnosis codes., A patient undergoes a Whipple procedure (pancreaticoduodenectomy) for pancreatic cancer. Post-operatively, the patient develops significant exocrine pancreatic insufficiency.K86.81 is used to represent the post-surgical complication.
Complete medical history, physical examination findings, laboratory results (e.g., fecal fat analysis, pancreatic enzyme tests), and imaging studies (e.g., abdominal ultrasound, CT scan) supporting the diagnosis of exocrine pancreatic insufficiency are required for accurate coding.
** The severity of exocrine pancreatic insufficiency may vary widely.Additional codes may be necessary to fully capture the complexity of the patient's condition and related symptoms.
- Payment Status: Active
- Modifier TC rule: Not applicable.K86.81 is a diagnosis code, not a procedure code.
- Specialties:Gastroenterology, Endocrinology, General Surgery
- Place of Service:Office, Hospital (Inpatient and Outpatient), Skilled Nursing Facility