K86.1

HCC Category Mapping

What This Code Means

Long-term inflammation of the pancreas from causes other than alcohol, such as autoimmune conditions, genetic factors, or unknown causes.

Coding Tips

• •Use this code when the cause is not alcohol-related; investigate and document the etiology if known
• •May require additional codes for underlying conditions like cystic fibrosis or autoimmune pancreatitis

Clinical Significance

Other chronic pancreatitis encompasses non-alcoholic causes of progressive pancreatic inflammation and fibrosis, leading to functional pancreatic insufficiency. This condition requires lifelong enzyme replacement therapy and diabetes management with treatment of underlying causes.

Documentation Requirements

• ✓Evidence of chronic pancreatic inflammation and fibrosis
• ✓Imaging showing pancreatic calcifications, atrophy, or ductal abnormalities
• ✓Clinical symptoms of pancreatic insufficiency
• ✓Exclusion of alcohol as the primary cause
• ✓Documentation of underlying etiology when known (genetic, autoimmune, idiopathic)
• ✓Evidence of exocrine pancreatic insufficiency
• ✓Development of pancreatic diabetes
• ✓Chronic abdominal pain pattern

Commonly Confused Codes