ICD-10 Logo
ICDxICD-10 Medical Coding
ICD-10 Logo
ICDxICD-10 Medical Coding
ICD 10 CodesDiagnoses
ICD 10 CodesDiagnoses
ICD-10 Logo
ICDxICD-10 Medical Coding

Comprehensive ICD-10-CM code reference with AI-powered search capabilities.

© 2025 ICD Code Compass. All rights reserved.

Browse

  • All Chapters
  • All Categories
  • Diagnoses

Tools

  • AI Code Search
ICD-10-CM codes are maintained by the CDC and CMS. This tool is for reference purposes only.
v1.0.0
ICD-10 Guide
ICD-10 CodesK85.92

K85.92

Billable

Acute pancreatitis with infected necrosis, unspecified

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

Code Description

ICD-10 K85.92 is a billable code used to indicate a diagnosis of acute pancreatitis with infected necrosis, unspecified.

Key Diagnostic Point:

Acute pancreatitis with infected necrosis, unspecified, is a severe form of pancreatitis characterized by inflammation of the pancreas accompanied by the presence of necrotic pancreatic tissue that has become infected. The pancreas is a vital organ located behind the stomach, responsible for producing digestive enzymes and hormones such as insulin. Infected necrosis can occur due to various causes, including gallstones, chronic and excessive alcohol consumption, or metabolic disorders. Clinically, patients may present with severe abdominal pain, nausea, vomiting, fever, and signs of systemic infection. The disease can progress rapidly, leading to complications such as sepsis, organ failure, and even death if not promptly managed. Diagnosis typically involves imaging studies such as CT scans or MRIs to assess the extent of necrosis and infection, alongside laboratory tests to evaluate pancreatic enzyme levels and signs of infection. Early recognition and intervention are crucial to improve outcomes and reduce morbidity associated with this condition.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires imaging and laboratory tests to confirm diagnosis and assess severity.
  • Treatment complexity: Involves multidisciplinary management including surgery, antibiotics, and supportive care.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other types of pancreatitis.

Audit Risk Factors

  • Common coding errors: Misclassification of the type of pancreatitis or failure to document the presence of necrosis.
  • Documentation gaps: Incomplete clinical notes regarding the patient's condition and treatment.
  • Billing challenges: Potential denials due to lack of supporting documentation for the severity of the condition.

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

General 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

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K85.92 lies in its association with severe morbidity and mortality rates. Acute pancreatitis with infected necrosis can lead to prolonged hospital stays, increased healthcare costs, and significant impacts on patient quality of life. Understanding the epidemiology of this condition is crucial for healthcare providers, as it affects a substantial portion of the population, particularly those with risk factors such as obesity, alcohol use, and gallbladder disease. Quality measures related to timely diagnosis and effective management are essential for improving patient outcomes.

ICD-9 vs ICD-10

The clinical significance of K85.92 lies in its association with severe morbidity and mortality rates. Acute pancreatitis with infected necrosis can lead to prolonged hospital stays, increased healthcare costs, and significant impacts on patient quality of life. Understanding the epidemiology of this condition is crucial for healthcare providers, as it affects a substantial portion of the population, particularly those with risk factors such as obesity, alcohol use, and gallbladder disease. Quality measures related to timely diagnosis and effective management are essential for improving patient outcomes.

Reimbursement & Billing Impact

reimbursement considerations include the severity of the condition and the necessity for surgical intervention or prolonged hospitalization. It is essential to follow coding best practices to ensure accurate billing and minimize the risk of audits or denials related to insufficient documentation.

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 K85.92?

K85.92 covers cases of acute pancreatitis where there is infected necrosis of the pancreatic tissue, which may arise from various etiologies such as gallstones, alcohol use, or metabolic disorders. It is important to document the presence of infection and necrosis as part of the clinical assessment.

When should K85.92 be used instead of related codes?

K85.92 should be used when there is clear evidence of infected necrosis in acute pancreatitis. If the condition is acute pancreatitis without necrosis, K85.90 should be used instead. Accurate differentiation is crucial for appropriate treatment and billing.

What documentation supports K85.92?

Documentation should include clinical findings of infected necrosis, imaging results confirming necrosis, laboratory tests indicating infection, and a detailed treatment plan. This evidence is critical for justifying the use of K85.92 in billing and coding.