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ICD-10 Guide
ICD-10 CodesK85.82

K85.82

Billable

Other acute pancreatitis with infected necrosis

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

Code Description

ICD-10 K85.82 is a billable code used to indicate a diagnosis of other acute pancreatitis with infected necrosis.

Key Diagnostic Point:

K85.82 refers to other acute pancreatitis with infected necrosis, a severe form of pancreatitis characterized by the presence of necrotic pancreatic tissue that becomes infected. Clinically, patients may present with severe abdominal pain, nausea, vomiting, and fever. The anatomy involved includes the pancreas, which is located behind the stomach and plays a crucial role in digestion and glucose metabolism. Disease progression can lead to systemic inflammatory response syndrome (SIRS), multi-organ failure, and sepsis if not promptly managed. Diagnostic considerations include imaging studies such as CT scans to identify necrosis and infection, along with laboratory tests to assess pancreatic enzyme levels and signs of infection. Early recognition and intervention are critical to improving patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassifying the type of pancreatitis or failing to document the presence of infection.
  • Documentation gaps may arise from insufficient clinical notes on the severity and complications of the condition.
  • Billing challenges can occur if the medical necessity for imaging and surgical interventions is not clearly documented.

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

Surgery

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

K85.82 has significant clinical implications, as it is associated with high morbidity and mortality rates. The condition can lead to increased healthcare utilization, including hospital admissions and surgical interventions. Understanding the epidemiology of infected necrosis in acute pancreatitis can help healthcare providers implement preventive measures and improve patient outcomes. Quality measures may focus on timely diagnosis and management of complications to reduce the burden on healthcare systems.

ICD-9 vs ICD-10

K85.82 has significant clinical implications, as it is associated with high morbidity and mortality rates. The condition can lead to increased healthcare utilization, including hospital admissions and surgical interventions. Understanding the epidemiology of infected necrosis in acute pancreatitis can help healthcare providers implement preventive measures and improve patient outcomes. Quality measures may focus on timely diagnosis and management of complications to reduce the burden on healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the necessity of interventions such as imaging or surgical procedures. Common denials may occur if documentation does not clearly establish the diagnosis or if the medical necessity for treatment is not justified. Best practices include ensuring that all clinical notes are comprehensive and that coding accurately reflects the patient's condition and treatment.

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 K85.82?

K85.82 covers cases of acute pancreatitis that are complicated by infected necrosis of the pancreas, which may arise from various etiologies including gallstones, alcohol use, or hyperlipidemia.

When should K85.82 be used instead of related codes?

K85.82 should be used when there is clear evidence of infected necrosis, as opposed to K85.80, which is for acute pancreatitis without necrosis. Documentation must support the diagnosis of infection.

What documentation supports K85.82?

Documentation should include clinical findings of infected necrosis, imaging results confirming necrosis, laboratory tests indicating infection, and treatment plans that reflect the severity of the condition.