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K85.9 ICD-10-CM Code: Acute pancreatitis, unspecified

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Billing Status: NO. This is a non-billable ICD-10-CM code: report a more specific billable code beneath it.

Coding at a Glance

Tabular directives
3 inclusion terms

Not billable · FY2027A non-billable heading in the tabular list: report a more specific code beneath it.

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.

IncludesWhat this code covers
  • acute (recurrent) pancreatitis
  • subacute pancreatitis
  • Pancreatitis NOS

CompareCheck ClaimView Related Codes

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K85.9 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 K85.9 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

Inclusion Terms

Alternative terms the tabular list files under this code.

  • Pancreatitis NOS

Coder workflow for K85.9

MedCoder structured workflow — derived from this code’s own official record

Before you code K85.9

  1. K85.9 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

    ReviewK85.90, K85.91, K85.92

    See the relationships section · Guide: How to choose an ICD-10-CM code →

  2. Unspecified does not mean incorrect. When the record gives no greater specificity, K85.9 may be the appropriate code. Check the record for detail that supports a more specific sibling — in this subcategory the siblings differ by acute versus chronic. An unspecified code is for records that do not provide the detail a more specific code needs; a query, not an assumption, is the route to specificity (Guidelines I.A.9.b, I.B.18).

    ReviewK85.0, K85.1, K85.2, K85.3, K85.8

    See the relationships section · Guide: Other vs unspecified (NEC vs NOS) →

Choose the right path

  1. Does the documentation support one of the more specific codes beneath K85.9?
    Yes → Select that code and continue the checks below on its own page.
    No → K85.9 cannot be reported as written; query for the specificity its subcategory needs.

    ReviewK85.90, K85.91, K85.92

  2. Does the record document the detail a more specific sibling code needs?
    Yes → Review the specific siblings in this subcategory.
    No → Continue — K85.9 is appropriate when the documentation goes no further.

    ReviewK85.0, K85.1, K85.2, K85.3, K85.8

Consider K85.9. Then confirm the code is valid for the date of service in the Verify section.

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).
Any detail beyond this code’s title
What the record states that a more specific sibling code would capture — or its absence, which itself supports the unspecified code.

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Documentation: The provider documents the condition in the terms of this code’s title and records no further detail.

Coding question: Is a more specific sibling code supportable?

Path: Review the specific siblings in this subcategory and what each requires the record to state.

Reason: A more specific code needs documentation of the distinguishing element; without it the unspecified code is appropriate, and a provider query is the route to specificity (Guidelines I.A.9.b, I.B.18).

ReviewK85.0, K85.1, K85.2, K85.3, K85.8

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

Acute pancreatitis, unspecified is a non-billable ICD-10-CM category code (K85.9). A more specific billable subcode must be selected for claims submission.

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

Verify Before Coding

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 K85.9 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 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.

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 category (CCSR)

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

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, 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, K86.2 — Cyst of pancreas, K86.3 — Pseudocyst of pancreas, K86.8 — Other specified diseases of pancreas, K86.81 — Exocrine pancreatic insufficiency, K86.89 — Other specified diseases of pancreas, +14 more

Contextual Map

Every relationship of K85.9 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 K85.9 with this related code in Claim Check

Hierarchy

Referenced by Code First instructions

Clinical classification (CCSR)

Nearest codes (24)

Change history (2)

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.

Common coding questions

MedCoder editorial

Can K85.9 be billed directly?

No. K85.9 (Acute pancreatitis, unspecified) is a non-billable ICD-10-CM category code. A more specific billable subcode must be selected based on clinical documentation.

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
Claim edits Official source data
CMS Definitions of Medicare Code Edits — v44.0 (October 2026) 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 20, 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. "K85.9 — Acute pancreatitis, unspecified." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k85.9-acute-pancreatitis-unspecified

Change history

  • FY2017 — October 1, 2016
    Became a non-billable header
    FY2017 changes
  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Acute pancreatitis, unspecified

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K85.9 in its code family, with their registry titles.

View all codes in the K85 family