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K86.0 ICD-10-CM Code: Alcohol-induced chronic pancreatitis

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
4 Excludes2 · 2 use-additional codes · 1 code-also instruction
Risk adjustment
CMS-HCC V28: 1 category · CMS-HCC V22 category 34 · RxHCC V08 category 65

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.

Use additional codeReport with this code when documented
  • code to identify:
  • alcohol abuse and dependence (F10.-)
Code alsoMay be needed with this code
  • exocrine pancreatic insufficiency (K86.81)
Excludes2Not included here; may be reported together
  • alcohol induced acute pancreatitis (K85.2-)
  • fibrocystic disease of pancreas (E84.-)
  • islet cell tumor (of pancreas) (D13.7)
  • pancreatic steatorrhea (K90.3)

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.

CompareCheck ClaimView Related Codes

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)

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.

Risk Adjustment (CMS-HCC)

Payment categories this diagnosis maps to under CMS-HCC V28, payment year 2026.

  • HCC 79 — Chronic Pancreatitis

Other models: CMS-HCC V22 HCC 34 · RxHCC V08 HCC 65

Risk scores depend on the enrollee's full accepted diagnosis set and segment; a category mapping alone does not determine payment.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K86.0 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 K86.0 itself; “inherited from” names the category or block whose note applies here.

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Code Also

Additional codes that may be required to fully describe the encounter.

  • exocrine pancreatic insufficiency (K86.81)

Use Additional Code

Supplementary codes the tabular list directs you to add.

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

Coder workflow for K86.0

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

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 conditions the Use Additional Code note names
Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

  • Excludes2 — not part of K86.0(4 notes)

    Coding workflow: The conditions named in this note are not included in K86.0. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

    CompareK85.2, E84, D13.7, K90.3

    See the official tabular notes · Guidelines I.A.12.b

  • Use Additional Code — after identifying K86.0(2 notes)

    Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with K86.0 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

    ReviewF10

    See the official tabular notes · Guidelines I.A.13

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    ReviewK86.81

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

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

Documentation: A condition the Use Additional Code note names is documented.

Coding question: Is a second code reported with K86.0?

Path: Review the Use Additional Code note and the code it names.

Reason: The additional code is reported when the record documents the condition; a conditional instruction applies only when its condition is met (Guidelines I.A.13).

ReviewF10

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.

Don’t confuse K86.0 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K86.0 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

  • K86.9— Specificity relationship (Review)

    Overlapping diagnoses in the same category.

    Overlapping codes in the same category — the documentation decides which is the more specific fit.

    What moves you there: A record that documents no more than “Disease of pancreas, unspecified” takes K86.9; specificity in the record moves it back here.

    Full comparison: K86.0 vs K86.9 →

  • K85.2— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of alcohol induced acute pancreatitis adds K85.2; it is not part of this code and both may be reported when both are documented.

    Full comparison: K86.0 vs K85.2 →

  • E84— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of fibrocystic disease of pancreas adds E84; it is not part of this code and both may be reported when both are documented.

    Full comparison: K86.0 vs E84 →

  • D13.7— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of islet cell tumor (of pancreas) adds D13.7; it is not part of this code and both may be reported when both are documented.

    Full comparison: K86.0 vs D13.7 →

  • K90.3— Excludes2 relationship (Informational)

    Distinct conditions — both may be reported.

    A distinct condition — both may be reported when both are documented.

    What moves you there: Documentation of pancreatic steatorrhea adds K90.3; it is not part of this code and both may be reported when both are documented.

    Full comparison: K86.0 vs K90.3 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

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

Alcohol-induced chronic pancreatitis is a billable ICD-10-CM diagnosis code (K86.0).

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

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Decision Points

The directives on this code's own record, as a pre-claim checklist.

  1. 2 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
  2. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  3. 4 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

  • CC 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 K86.0 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: K85.2 — Alcohol induced acute pancreatitis.

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 K86.-).

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: CC — 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 27 clinically related codes on its CMS exclusion list.

Named in the grouper logic of 3 MS-DRGs: DRG 438 (MDC 07), DRG 439 (MDC 07), DRG 440 (MDC 07).

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 CC — 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.

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, K85.22 — 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, K86.1 — Other chronic pancreatitis, K86.2 — Cyst of pancreas, K86.3 — Pseudocyst of pancreas, K86.81 — Exocrine pancreatic insufficiency, K86.89 — Other specified diseases of pancreas, K86.9 — Disease of pancreas, unspecified, +6 more

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Pancreatitis) for risk-adjusted payment.

K86.1 — Other chronic pancreatitis

Same clinical category (CCSR)

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

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, K85.91 — Acute pancreatitis with uninfected necrosis, unspecified, K85.92 — Acute pancreatitis with infected necrosis, unspecified, 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, K86.9 — Disease of pancreas, unspecified, K90.3 — Pancreatic steatorrhea, +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.

B25.2 — Cytomegaloviral pancreatitis (cytomegaloviral), B26.3 — Mumps pancreatitis (mumps), K85.00 — Idiopathic acute pancreatitis without necrosis or infection (acute, idiopathic), K85.01 — Idiopathic acute pancreatitis with uninfected necrosis (acute, idiopathic, with necrosis), K85.02 — Idiopathic acute pancreatitis with infected necrosis (acute, idiopathic, with necrosis, infected), K85.10 — Biliary acute pancreatitis without necrosis or infection (gallstone), K85.11 — Biliary acute pancreatitis with uninfected necrosis (gallstone, with necrosis), K85.12 — Biliary acute pancreatitis with infected necrosis (gallstone, with necrosis, infected), K85.20 — Alcohol induced acute pancreatitis without necrosis or infection (acute, alcohol induced), K85.21 — Alcohol induced acute pancreatitis with uninfected necrosis (acute, alcohol induced, with necrosis), K85.22 — Alcohol induced acute pancreatitis with infected necrosis (acute, alcohol induced, with necrosis, infected), K85.30 — Drug induced acute pancreatitis without necrosis or infection (acute, drug induced), K85.31 — Drug induced acute pancreatitis with uninfected necrosis (acute, drug induced, with necrosis), K85.32 — Drug induced acute pancreatitis with infected necrosis (acute, drug induced, with necrosis, infected), K85.80 — Other acute pancreatitis without necrosis or infection (interstitial, acute), K85.81 — Other acute pancreatitis with uninfected necrosis (acute, specified NEC, with necrosis), K85.82 — Other acute pancreatitis with infected necrosis (acute, specified NEC, with necrosis, infected), K85.90 — Acute pancreatitis without necrosis or infection, unspecified, K85.91 — Acute pancreatitis with uninfected necrosis, unspecified (with necrosis), K85.92 — Acute pancreatitis with infected necrosis, unspecified (with necrosis, infected), +1 more

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.

HbA1c Test (Glycated Hemoglobin), Blood Glucose Test, Fecal Occult Blood Test (FOBT), Lipid Panel

Contextual Map

Every relationship of K86.0 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 K86.0 with these 4 related codes in Claim Check

Hierarchy

Excludes2

Use Additional Code

Code Also

Referenced by Excludes2 notes

Referenced by Code First instructions

Clinical classification (CCSR)

Risk adjustment (CMS-HCC)

  • HCC 79 — Chronic Pancreatitis [CMS-HCC]— CMS-HCC V28 · 2026

MS-DRG Grouper

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

Index entries

  • Pancreatitis (annular) (apoplectic) (calcareous) (edematous) (hemorrhagic) (malignant) (subacute) (suppurative), chronic (infectious), alcohol-induced[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2027

Nearest codes

Change history

  • FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

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
Risk adjustment Official source data
2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release 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. "K86.0 — Alcohol-induced chronic pancreatitis." ICD-10-CM FY2027. https://medcoder.ai/icd10/code/k86.0-alcohol-induced-chronic-pancreatitis

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Alcohol-induced chronic pancreatitis

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027, and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K86.0 in its code family, with their registry titles.

View all codes in the K86 family