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ICD-10/K85.12

K85.12 ICD-10-CM Code: Biliary acute pancreatitis with infected 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 infected necrosis is a billable ICD-10-CM diagnosis code (K85.12).

Official Tabular Instructional Notes

Sequencing, inclusion, and exclusion notes published for K85.12 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

Change history

  • FY2017 — 2016-10-01
    Added to the code set
    Biliary acute pancreatitis with infected 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.

Contextual Map

Every relationship of K85.12 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), infected[Index term]
  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), acute (without necrosis or infection), gallstone (without necrosis or infection), with necrosis (uninfected), infected[Index term]
  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), gallstone (without necrosis or infection), with necrosis (uninfected), infected[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]
  • K85.11 — Biliary acute pancreatitis with uninfected necrosis [Sibling]
  • and 16 more

Change history

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

Referenced by Other Codes

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.

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.

Official ICD-10-CM tabular notes on other codes that name K85.12 or its code family.

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

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K85.12 in its code family, with their registry titles.

  • 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
  • K85.11 — Biliary acute pancreatitis with uninfected 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

View all codes in the K85 family

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