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K85.11 ICD-10-CM Code: Biliary acute pancreatitis with uninfected necrosis

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Inpatient Payment Groups (MS-DRG)

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43.0, Appendix B.

  • MS-DRG 438 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC (MDC 07)
  • MS-DRG 439 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC (MDC 07)
  • MS-DRG 440 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC (MDC 07)
  • MS-DRG 791 — PREMATURITY WITH MAJOR PROBLEMS (MDC 15)
  • MS-DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Official Registry Overview & Definition

Biliary acute pancreatitis with uninfected necrosis is a billable ICD-10-CM diagnosis code (K85.11).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for K85.11 in the official ICD-10-CM tabular list.

Includes

Conditions the official ICD-10-CM tabular list includes under this code.

  • acute (recurrent) pancreatitis
  • subacute pancreatitis

Indexed Clinical Terms (3)

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code.

  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), acute (without necrosis or infection), biliary (without necrosis or infection), with necrosis (uninfected)
  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), acute (without necrosis or infection), gallstone (without necrosis or infection), with necrosis (uninfected)
  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), gallstone (without necrosis or infection), with necrosis (uninfected)

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Biliary acute pancreatitis with uninfected necrosis
    FY2017 changes

Verify Before Coding

  • MCC as a secondary diagnosis (FY2026). Can raise the stay's MS-DRG severity tier.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim.

Relationships & Classification

Other codes that name K85.11 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

1 Code First instructions: E08 (via K85.-).

Potential MS-DRG Relationships (FY2026)

MCC — Major Complication or Comorbidity. Reported as a secondary diagnosis, this code raises the stay's MS-DRG severity tier — except when the principal diagnosis is one of 24 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 5 MS-DRGs: DRG 438 (MDC 07), DRG 439 (MDC 07), DRG 440 (MDC 07), DRG 791 (MDC 15), DRG 793 (MDC 15).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG020 — Pancreatic disorders (excluding diabetes) (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical process (MS-DRG)

Acts as MCC — raises the severity of other admissions. CMS groups these diagnoses into one MS-DRG principal-diagnosis exclusion process — a CC/MCC on this list never raises severity when the principal diagnosis is also on it.

B25.2 — Cytomegaloviral pancreatitis, E16.8 — Other specified disorders of pancreatic internal secretion, K85.00 — Idiopathic acute pancreatitis without necrosis or infection, K85.01 — Idiopathic acute pancreatitis with uninfected necrosis, K85.02 — Idiopathic acute pancreatitis with infected necrosis, K85.10 — Biliary acute pancreatitis without necrosis or infection, K85.12 — Biliary acute pancreatitis with infected necrosis, K85.20 — Alcohol induced acute pancreatitis without necrosis or infection, K85.21 — Alcohol induced acute pancreatitis with uninfected necrosis, K85.22 — Alcohol induced acute pancreatitis with infected necrosis, K85.30 — Drug induced acute pancreatitis without necrosis or infection, K85.31 — Drug induced acute pancreatitis with uninfected necrosis, K85.32 — Drug induced acute pancreatitis with infected necrosis, K85.80 — Other acute pancreatitis without necrosis or infection, K85.81 — Other acute pancreatitis with uninfected necrosis, K85.82 — Other acute pancreatitis with infected necrosis, K85.90 — Acute pancreatitis without necrosis or infection, unspecified, K85.91 — Acute pancreatitis with uninfected necrosis, unspecified, K85.92 — Acute pancreatitis with infected necrosis, unspecified, K86.0 — Alcohol-induced chronic pancreatitis, +6 more

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Pancreatic disorders (excluding diabetes)).

B25.2 — Cytomegaloviral pancreatitis, B26.3 — Mumps pancreatitis, K85.0 — Idiopathic acute pancreatitis, K85.00 — Idiopathic acute pancreatitis without necrosis or infection, K85.01 — Idiopathic acute pancreatitis with uninfected necrosis, K85.02 — Idiopathic acute pancreatitis with infected necrosis, K85.1 — Biliary acute pancreatitis, K85.10 — Biliary acute pancreatitis without necrosis or infection, K85.12 — Biliary acute pancreatitis with infected necrosis, K85.2 — Alcohol induced acute pancreatitis, K85.20 — Alcohol induced acute pancreatitis without necrosis or infection, K85.21 — Alcohol induced acute pancreatitis with uninfected necrosis, K85.22 — Alcohol induced acute pancreatitis with infected necrosis, K85.3 — Drug induced acute pancreatitis, K85.30 — Drug induced acute pancreatitis without necrosis or infection, K85.31 — Drug induced acute pancreatitis with uninfected necrosis, K85.32 — Drug induced acute pancreatitis with infected necrosis, K85.8 — Other acute pancreatitis, K85.80 — Other acute pancreatitis without necrosis or infection, K85.81 — Other acute pancreatitis with uninfected necrosis, +14 more

Lab tests where this diagnosis supports Medicare coverage

Medicare's National Coverage Determinations list this diagnosis as medical justification for these lab tests.

Blood Glucose Test, Fecal Occult Blood Test (FOBT), Lipid Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of K85.11 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Hierarchy

  • K00-K95 — Chapter 11: Diseases of the Digestive System (K00-K95) (K00-K95) [Hierarchy]
  • K80-K87 — Disorders of gallbladder, biliary tract and pancreas [Hierarchy]

Referenced by Code First instructions

  • E08 — Diabetes mellitus due to underlying condition [Code First](via K85.-): “pancreatitis and other diseases of the pancreas (K85-K86.-)” · check together

Clinical classification (CCSR)

  • DIG020 — Pancreatic disorders (excluding diabetes) [CCSR]

Potential MS-DRG

  • MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”
  • DRG 438 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC [MS-DRG]: “DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC (MDC 07)”
  • DRG 439 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC [MS-DRG]: “DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC (MDC 07)”
  • DRG 440 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC [MS-DRG]: “DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC (MDC 07)”
  • DRG 791 — PREMATURITY WITH MAJOR PROBLEMS [MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”
  • DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS [MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”

MDC crossing · procedures (2481)

  • MDC 07 — Diseases and Disorders of the Hepatobiliary System and Pancreas [MDC crossing]: “Diseases and Disorders of the Hepatobiliary System and Pancreas — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • MDC 15 — Newborns and Other Neonates with Conditions Originating in Perinatal Period [MDC crossing]: “Newborns and Other Neonates with Conditions Originating in Perinatal Period — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs.”
  • 008W0ZZ — Division of Cervical Spinal Cord, Open Approach [Same-MDC procedure]: “Division of Cervical Spinal Cord, Open Approach — grouped in MDC 07, the procedure side of this code's crossing.” · check together
  • 008W3ZZ — Division of Cervical Spinal Cord, Percutaneous Approach [Same-MDC procedure]: “Division of Cervical Spinal Cord, Percutaneous Approach — grouped in MDC 07, the procedure side of this code's crossing.” · check together
  • 008W4ZZ — Division of Cervical Spinal Cord, Percutaneous Endoscopic Approach [Same-MDC procedure]: “Division of Cervical Spinal Cord, Percutaneous Endoscopic Approach — grouped in MDC 07, the procedure side of this code's crossing.” · check together
  • 008X0ZZ — Division of Thoracic Spinal Cord, Open Approach [Same-MDC procedure]: “Division of Thoracic Spinal Cord, Open Approach — grouped in MDC 07, the procedure side of this code's crossing.” · check together
  • 008X3ZZ — Division of Thoracic Spinal Cord, Percutaneous Approach [Same-MDC procedure]: “Division of Thoracic Spinal Cord, Percutaneous Approach — grouped in MDC 07, the procedure side of this code's crossing.” · check together
  • and 2476 more

Index entries

  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), acute (without necrosis or infection), biliary (without necrosis or infection), with necrosis (uninfected)[Index term]
  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), acute (without necrosis or infection), gallstone (without necrosis or infection), with necrosis (uninfected)[Index term]
  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), gallstone (without necrosis or infection), with necrosis (uninfected)[Index term]

Nearest codes (24)

  • K85 — Acute pancreatitis [Sibling]
  • K85.0 — Idiopathic acute pancreatitis [Sibling]
  • K85.00 — Idiopathic acute pancreatitis without necrosis or infection [Sibling]
  • K85.01 — Idiopathic acute pancreatitis with uninfected necrosis [Sibling]
  • K85.02 — Idiopathic acute pancreatitis with infected necrosis [Sibling]
  • K85.1 — Biliary acute pancreatitis [Sibling]
  • K85.10 — Biliary acute pancreatitis without necrosis or infection [Sibling]
  • K85.12 — Biliary acute pancreatitis with infected necrosis [Sibling]
  • and 16 more

Change history

  • FY2017 — Added to the code set [Change history]

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K85.11 in its code family, with their registry titles.

  • K85.00 — Idiopathic acute pancreatitis without necrosis or infection
  • K85.01 — Idiopathic acute pancreatitis with uninfected necrosis
  • K85.02 — Idiopathic acute pancreatitis with infected necrosis
  • K85.1 — Biliary acute pancreatitis
  • K85.10 — Biliary acute pancreatitis without necrosis or infection
  • K85.12 — Biliary acute pancreatitis with infected necrosis
  • K85.2 — Alcohol induced acute pancreatitis
  • K85.20 — Alcohol induced acute pancreatitis without necrosis or infection
  • K85.21 — Alcohol induced acute pancreatitis with uninfected necrosis
  • K85.22 — Alcohol induced acute pancreatitis with infected necrosis

View all codes in the K85 family