K85.22 ICD-10-CM Code: Alcohol induced acute pancreatitis with infected necrosis
Compare with another codeCheck this code on a claim
Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.
Coding at a Glance
- Tabular directives
- 2 inclusion terms · 1 Excludes2
Billable · FY2027A valid, specific ICD-10-CM code, reportable for dates of service in FY2027.
What you need to know
Source: CMS/NCHS Official ICD-10-CM tabular notes, quoted. From the CMS/NCHS tabular list for the release in force. A note the category or block publishes applies to this code too; the Instructions section marks which is which.
- Excludes2Not included here; may be reported together
- alcohol induced chronic pancreatitis (K86.0)
- IncludesWhat this code covers
- acute (recurrent) pancreatitis
- subacute pancreatitis
Most relevant related codes MedCoder-derived
Read off the official notes above and this code’s own position in the tabular list. Which to report is a documentation question; Compare shows the two side by side.
Inpatient Payment Groups (MS-DRG)
Potential MS-DRG participation — not a DRG assignment.
MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v44, 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.
Coding instructions
Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K85.22 in the official ICD-10-CM tabular list, quoted as published.
Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2027Effective: October 1, 2026
Trace:FY2027 changesChange historyRelease, file and checksum
Notes without a marker are published on K85.22 itself; “inherited from” names the category or block whose note applies here.
Includes
Conditions the official ICD-10-CM tabular list includes under this code.
- acute (recurrent) pancreatitis
- subacute pancreatitis
Source: inherited from K85
Excludes2 — Not Included Here
Conditions not covered by this code, but which may be reported alongside it when both are present.
- alcohol induced chronic pancreatitis (K86.0) Compare K85.22 vs K86.0 →
Source: inherited from K85.2
Coder workflow for K85.22
MedCoder structured workflow — derived from this code’s own official record
Before you code K85.22
- K85.22’s title joins a condition with an associated condition or complication. Confirm each component is documented. Where the classification presumes the link through the “with” convention, only a provider statement that the conditions are unrelated defeats it. A combination code is assigned only when it fully identifies the documented conditions; a required second code for the stage, type or manifestation is still reported when the notes ask for it (Guidelines I.B.9, I.A.15).
Documentation check
- The provider’s diagnostic statement
- Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).
- Acuity
- Acute or chronic as documented; when both are documented and separate codes exist, both are reported with the acute code first (Guidelines I.B.8).
- The associated condition or complication
- Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).
Official instructions as workflow
Excludes2 — not part of K85.22(1 note)
Coding workflow: The conditions named in this note are not included in K85.22. When the record documents both, both may be reported; the note is a boundary, not a prohibition.
CompareK86.0
See the official tabular notes · Guidelines I.A.12.b
Coding decision scenarios
Pattern scenarios for this code’s structure — decision rules, not clinical cases
Documentation: Only one of the components this code’s title joins is documented.
Coding question: Is K85.22 supported?
Path: Review the code for the documented component on its own.
Reason: A combination code is assigned only when it fully identifies the documented conditions; otherwise the documented component takes its own code (Guidelines I.B.9).
Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.
Coding context
Guidelines, coding notes, decision aids, relationships (with MS-DRG and CCSR classification), hierarchy, HCC, coverage and the context map: what a coder reaches for after the core. Each section names whether it is official source data, a MedCoder-derived relationship or MedCoder editorial.
Code Overview
MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.
Official Coding Guidelines
Official source data — quoted verbatim from the CMS/NCHS Official Guidelines
Verbatim excerpts from the ICD-10-CM Official Guidelines for Coding and Reporting (CMS/NCHS) that govern this code.
Chapter 5: Mental, Behavioral and Neurodevelopmental disorders (F01 – F99)
4) Medical Conditions Due to Psychoactive Substance Use, Abuse and Dependence Medical conditions due to substance use, abuse, and dependence are not classified as substance-induced disorders. Assign the diagnosis code for the medical condition as directed by the Alphabetical Index along with the appropriate psychoactive substance use, abuse or dependence code. For example, for alcoholic pancreatitis due to alcohol dependence, assign the appropriate code from subcategory K85.2, Alcohol induced acute pancreatitis, and the appropriate code from subcategory F10.2, such as code F10.20, Alcohol dependence, uncomplicated. It would not be appropriate to assign code F10.288, Alcohol dependence with other alcohol-induced disorder.
Verify Before Coding
- MCC as a secondary diagnosis (FY2027). 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 in Claim Check.
Relationships & Classification
MedCoder-derived relationships — computed from published CMS and AHRQ datasets
Other codes that name K85.22 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.
Referenced by 1 Excludes2 note: K86.0 — Alcohol-induced chronic pancreatitis (via K85.2.-).
These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.
Referenced by 1 Code First instruction: E08 — Diabetes mellitus due to underlying condition (via K85.-).
Each of these codes carries a Code First note naming this condition — when that code is reported, THIS code is sequenced first, ahead of it.
MS-DRG Grouper Relationships (FY2027)
Potential MS-DRG participation — not a DRG assignment.
FY2027 MS-DRG: 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, 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, K85.11 — Biliary acute pancreatitis with uninfected necrosis, 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, K85.30 — 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, K86.1 — Other chronic pancreatitis, +3 more
Same clinical category (CCSR)
AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Pancreatic disorders (excluding diabetes)).
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, K85.11 — Biliary acute pancreatitis with uninfected necrosis, 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, K85.3 — 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, K85.82 — Other acute pancreatitis with infected necrosis, K85.9 — Acute pancreatitis, unspecified, K85.90 — Acute pancreatitis without necrosis or infection, unspecified, +14 more
Same Index main term, other category
The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Pancreatitis”; these codes share that main term but sit in a different category of the Tabular List.
A52.74 — Syphilis of liver and other viscera (syphilitic), B25.2 — Cytomegaloviral pancreatitis (cytomegaloviral), B26.3 — Mumps pancreatitis (mumps), K86.0 — Alcohol-induced chronic pancreatitis (chronic, alcohol-induced), K86.1 — Other chronic pancreatitis (cystic)
Lab tests where this diagnosis supports Medicare coverage (NCD)
Medicare's National Coverage Determination (NCD) program lists 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 K85.22 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.
Run K85.22 with these 2 related codes in Claim Check
Hierarchy
- K00-K95 — Chapter 11: Diseases of the Digestive System (K00-K95) (K00-K95)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K80-K87 — Disorders of gallbladder, biliary tract and pancreas[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
Referenced by Excludes2 notes
- K86.0 — Alcohol-induced chronic pancreatitis[Excludes2](via K85.2.-): “alcohol induced acute pancreatitis (K85.2-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
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.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2027
Clinical classification (CCSR)
- DIG020 — Pancreatic disorders (excluding diabetes)[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
MS-DRG Grouper
- MCC — Major Complication or Comorbidity [MS-DRG severity]: “As a secondary diagnosis this code can raise the stay's MS-DRG severity tier (MCC).”— CMS MS-DRG Definitions Manual (Appendix C) · FY2027
- DRG 438 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC[MS-DRG]: “DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC (MDC 07)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 439 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC[MS-DRG]: “DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC (MDC 07)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 440 — DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC[MS-DRG]: “DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC (MDC 07)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 791 — PREMATURITY WITH MAJOR PROBLEMS[MS-DRG]: “PREMATURITY WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
- DRG 793 — FULL TERM NEONATE WITH MAJOR PROBLEMS[MS-DRG]: “FULL TERM NEONATE WITH MAJOR PROBLEMS (MDC 15)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2027
MDC crossing
- 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. 2,488 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2027
- 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.”— CMS MS-DRG Definitions Manual · FY2027
Index entries
- Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), acute (without necrosis or infection), alcohol induced (without necrosis or infection), with necrosis (uninfected), infected[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027
Nearest codes (24)
- K85 — Acute pancreatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.0 — Idiopathic acute pancreatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.00 — Idiopathic acute pancreatitis without necrosis or infection[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.01 — Idiopathic acute pancreatitis with uninfected necrosis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.02 — Idiopathic acute pancreatitis with infected necrosis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.1 — Biliary acute pancreatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.10 — Biliary acute pancreatitis without necrosis or infection[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- K85.11 — Biliary acute pancreatitis with uninfected necrosis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2027
- and 16 more
Change history
- FY2017 — Added to the code set[Change history]— CMS release files (code change ledger) · icd10cm-fy2017
Reference
Index terms and tables, published questions and FAQ, every source behind this page with its release and checksum, the date-of-service check and the complete change history.
Indexed Clinical Terms (1)
Official source data — entries quoted as published, in the Index’s own lookup phrasing
Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.
Sources for this page
Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.
- Code, title, tabular notes and index terms Official source data
- CMS/CDC ICD-10-CM FY2027 tabular list, index and tables, effective October 1, 2026 Release, file and checksum · Publisher’s page
- Coding guidelines Official source data
- ICD-10-CM Official Guidelines for Coding and Reporting (FY2027), quoted by section Release, file and checksum · Publisher’s page
- Claim edits Official source data
- CMS Definitions of Medicare Code Edits — v44.0 (October 2026) Release, file and checksum · Publisher’s page
- Inpatient payment groups Official source data
- CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v44 Release, file and checksum · Publisher’s page
- Change history and date-of-service validity Official source data
- CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page
- Comparisons, relationships and the contextual map MedCoder-derived relationship
- Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears
- Summary and FAQ answers MedCoder editorial explanation
- Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.
Current data releases:ICD-10-CM FY2027 · ICD-10-PCS FY2027 · HCPCS October 2026 · MS-DRG v44 · Medicare Code Editor v44.0 · NCCI PTP Q4 2026 · MUE Q4 2026 · NCD code lists 2026-01 · LCD export September 28, 2026 · All releases and sources
Labels on this page: Official source data · MedCoder-derived relationship · MedCoder editorial explanation. How to read the labels · All data sources and release dates · CMS coding rules
Cite this page
Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.
MedCoder.ai. "K85.22 — Alcohol induced acute pancreatitis with infected necrosis." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k85.22-alcohol-induced-acute-pancreatitis-with-infected-necrosis
Change history
- FY2017 — October 1, 2016Added to the code setAlcohol induced acute pancreatitis with infected necrosisFY2017 changes
Nearest Codes in This Family
Official ICD-10-CM classifications closest to K85.22 in its code family, with their registry titles.
- K85.11 — Biliary acute pancreatitis with uninfected necrosis
- 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
- K85.3 — 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