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ICD-10 Guide
ICD-10 CodesChapter 11: Diseases of the digestive systemK87

K87

Billable

Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere

Chapter 11:Diseases of the digestive system

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 K87 is a billable code used to indicate a diagnosis of disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere.

Key Diagnostic Point:

The ICD-10 Level 1 Category code K87 encompasses disorders of the gallbladder, biliary tract, and pancreas that are classified elsewhere in the ICD-10 system. This category is particularly important as it captures conditions that may arise as complications or secondary issues related to other diseases, such as infections, malignancies, or metabolic disorders. The clinical significance of K87 lies in its ability to provide a comprehensive understanding of how these organs can be affected by various underlying health conditions, thus aiding in proper diagnosis and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying conditions
  • Potential for overlapping symptoms
  • Need for precise documentation

Audit Risk Factors

  • Inadequate documentation of primary conditions
  • Misclassification of secondary disorders
  • Failure to link symptoms to underlying diseases

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 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

The clinical impact of K87 is significant, as it helps healthcare providers understand the interplay between various diseases and their effects on the gallbladder, biliary tract, and pancreas. This understanding is crucial for improving patient outcomes and managing complications effectively. Administratively, accurate coding under K87 can influence quality measures and population health initiatives, as it allows for better tracking of disease prevalence and management strategies within healthcare systems.

ICD-9 vs ICD-10

The clinical impact of K87 is significant, as it helps healthcare providers understand the interplay between various diseases and their effects on the gallbladder, biliary tract, and pancreas. This understanding is crucial for improving patient outcomes and managing complications effectively. Administratively, accurate coding under K87 can influence quality measures and population health initiatives, as it allows for better tracking of disease prevalence and management strategies within healthcare systems.

Reimbursement & Billing Impact

Reimbursement considerations may vary based on the complexity of the case and the specific treatments rendered. It is essential to ensure that all documentation is complete and reflects the patient's clinical picture accurately, as this will support the medical necessity of the services provided and facilitate appropriate reimbursement from payers.

Resources

Clinical References

  • •
    Official ICD-10 Guidelines for K87

Coding & Billing References

  • •
    Official ICD-10 Guidelines for K87

Frequently Asked Questions

What conditions are included in K87?

K87 includes disorders such as cholecystitis, pancreatitis, and biliary obstruction that are secondary to other diseases, such as diabetes or malignancies.

When should I use K87 codes?

K87 codes should be used when documenting gallbladder, biliary tract, or pancreatic disorders that are a direct result of another underlying condition, ensuring accurate representation of the patient's health status.

What documentation is required for K87?

Documentation must clearly indicate the primary condition leading to the gallbladder, biliary tract, or pancreatic disorder, including any relevant diagnostic tests and clinical findings.