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ICD-10 Guide
ICD-10 CodesK85.2

K85.2

Non-billable

Alcohol induced acute pancreatitis

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K85.2 is a used to indicate a diagnosis of alcohol induced acute pancreatitis.

Key Diagnostic Point:

Alcohol-induced acute pancreatitis is a condition characterized by the sudden inflammation of the pancreas due to excessive alcohol consumption. The pancreas, located behind the stomach, plays a crucial role in digestion and blood sugar regulation. Clinical presentation often includes severe abdominal pain, nausea, vomiting, and elevated levels of pancreatic enzymes in the blood. The disease can progress rapidly, leading to complications such as necrotizing pancreatitis, infection, or systemic inflammatory response syndrome (SIRS). Diagnosis typically involves a combination of clinical evaluation, laboratory tests (including serum amylase and lipase), and imaging studies such as ultrasound or CT scans to assess the extent of pancreatic damage. It is essential to differentiate alcohol-induced pancreatitis from other forms, such as gallstone-related pancreatitis, as management strategies may differ significantly. Early recognition and intervention are critical to prevent further complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires differential diagnosis and imaging studies.
  • Treatment complexity: Involves managing acute symptoms and potential complications.
  • Documentation requirements: Detailed clinical notes and lab results are necessary.
  • Coding specificity: Requires accurate coding to distinguish from other types of pancreatitis.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of pancreatitis.
  • Documentation gaps: Incomplete clinical notes or missing lab results.
  • Billing challenges: Potential denials due to lack of specificity in coding.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Internal Medicine

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Alcohol-induced acute pancreatitis has significant clinical implications, contributing to increased healthcare utilization and costs. It is a major cause of hospitalization among individuals with alcohol use disorders. Understanding the epidemiology of this condition can help healthcare providers implement preventive measures and improve management strategies, ultimately enhancing patient outcomes and reducing the burden on healthcare systems.

ICD-9 vs ICD-10

Alcohol-induced acute pancreatitis has significant clinical implications, contributing to increased healthcare utilization and costs. It is a major cause of hospitalization among individuals with alcohol use disorders. Understanding the epidemiology of this condition can help healthcare providers implement preventive measures and improve management strategies, ultimately enhancing patient outcomes and reducing the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and any complications that may arise. Common denials may occur if documentation does not clearly establish the link between alcohol use and the pancreatitis. Best practices include thorough documentation and coding specificity to avoid billing challenges.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K85.2?

K85.2 specifically covers acute pancreatitis caused by alcohol consumption. It is important to note that this code is used when the pancreatitis is directly attributed to alcohol use, distinguishing it from other causes such as gallstones or hyperlipidemia.

When should K85.2 be used instead of related codes?

K85.2 should be used when there is clear evidence of acute pancreatitis resulting from alcohol use. If the pancreatitis is due to other factors, such as gallstones or medications, the appropriate code should be selected instead.

What documentation supports K85.2?

Documentation should include a clear history of alcohol consumption, clinical findings consistent with acute pancreatitis, laboratory results showing elevated pancreatic enzymes, and imaging studies that support the diagnosis.