ICD-10 code for pancreatitis

The ICD-10-CM code for pancreatitis is K85.90 (Acute pancreatitis without necrosis or infection, unspecified). The official index lists 39 more specific codes, so check the documentation for details such as type, cause, site or severity before settling on K85.90.

Within K85.9, choose K85.90 (without necrosis or infection, unspecified) only when documentation doesn't support a more specific option: with uninfected necrosis, unspecified (K85.91) and with infected necrosis, unspecified (K85.92).

As a secondary diagnosis it is an MCC (major complication or comorbidity), which can move an inpatient stay into the highest-paying "with MCC" MS-DRG of its family, unless the principal diagnosis excludes it.

In MS-DRG v44.0, it is part of the grouping logic for DRG 438 (Disorders of Pancreas Except Malignancy with MCC, relative weight 1.5765), DRG 439 (Disorders of Pancreas Except Malignancy with CC, relative weight 0.8402), DRG 440 (Disorders of Pancreas Except Malignancy without CC/MCC, relative weight 0.5965), DRG 791 (Prematurity with Major Problems, relative weight 4.1075) and DRG 793 (Full Term Neonate with Major Problems, relative weight 4.2195), in MDC 07 (Diseases and Disorders of the Hepatobiliary System and Pancreas) and MDC 15 (Newborns and Other Neonates with Conditions Originating in the Perinatal Period), as a principal or secondary diagnosis. The DRG a claim lands in depends on the principal diagnosis, procedures and any CC/MCC secondary diagnoses.