Radiology Coding Alert

Acute and chronic forms will still have separate options under the new code set.

Discussions of increased specificity for ICD-10 codes often focus on needing to know the side of the body or anatomic area affected. But as the chronic pancreatitis codes reveal, you also may need to know the cause of the condition to choose the most appropriate ICD-10 code.

Diagnosis: As the name suggests, chronic pancreatitis is an inflammation (-itis) of the pancreas that doesn’t get better over time. Alcohol abuse is a common cause, but it’s not the only cause.

ICD-9-CM Code:

577.1, Chronic pancreatitis

       o NOS

       o Infectious

       o Interstitial

       o Pancreatitis:

   §  painless

   §  recurrent

   §  relapsing

ICD-10-CM Codes:

K86.0, Alcohol-induced chronic pancreatitis

       §  Use additional code to identify: alcohol abuse and dependence (F10.-)

  §  Exclu+des2: alcohol induced acute pancreatitis (K85.2)

K86.1, Other chronic pancreatitis

  §  Other chronic pancreatitis

       §  Chronic pancreatitis NOS

       §  Infectious chronic pancreatitis

       §  Recurrent chronic pancreatitis

       §  Relapsing chronic pancreatitis

ICD-9 coding rules: ICD-9 has one code for chronic pancreatitis. It includes chronic pancreatitis not otherwise specified (NOS), infectious, interstitial, painless, recurrent, or relapsing.

ICD-10 changes: When you start using ICD-10, you’ll have two chronic pancreatitis codes. One (K86.0) is for alcohol-induced chronic pancreatitis. When you choose this code, you should use an additional code from the F10.- range (Alcohol related disorders).

The second option (K86.1) is for other types of chronic pancreatitis, including NOS, infectious, recurrent, and relapsing. In the index, you’ll also find cystic, fibrous, and interstitial pancreatitis indexed to K86.1.

Documentation: To help you choose between K86.0 and K86.1, documentation should specify whether the pancreatitis is alcohol-induced, and if so, the nature of the alcohol abuse, dependence, or use so you may select the appropriate F10.- code. You also need documentation that confirms the pancreatitis is chronic rather than acute.

Coder tips: When the patient has acute pancreatitis, you should choose from the K85.- range (Acute pancreatitis):

·         K85.0, Idiopathic acute pancreatitis

·         K85.1, Biliary acute pancreatitis

·         K85.2, Alcohol induced acute pancreatitis

·         K85.3, Drug induced acute pancreatitis

·         K85.8, Other acute pancreatitis

·         K85.9, Acute pancreatitis, unspecified.

Remember: CMS has finalized the ICD-10 compliance date of Oct. 1, 2014. When ICD-10 goes into effect, you should apply the code set and official guidelines in effect for the date of service reported. Learn more at www.cms.gov/ICD10/ and www.cdc.gov/nchs/icd/icd10cm.htm#10update.