K86.81
BillableExocrine pancreatic insufficiency
HCC Category Mapping
RxHCCHCC 66 — Pancreatic Disease and Disorders
0.000What This Code Means
The pancreas does not produce enough digestive enzymes, leading to difficulty digesting food and nutrient absorption problems.
Coding Tips
- •Often results from chronic pancreatitis, cystic fibrosis, or pancreatic surgery; link to the underlying cause when present
- •Document if patient requires enzyme replacement therapy (pancreatic supplements)
Clinical Significance
Exocrine pancreatic insufficiency represents inadequate pancreatic enzyme production, leading to maldigestion and malabsorption of nutrients. This condition requires lifelong pancreatic enzyme replacement therapy and nutritional monitoring to prevent deficiency states.
Documentation Requirements
- ✓Clinical evidence of maldigestion (steatorrhea, weight loss)
- ✓Pancreatic function tests showing reduced enzyme output
- ✓Documentation of fat-soluble vitamin deficiencies
- ✓History of chronic pancreatitis, cystic fibrosis, or pancreatic surgery
- ✓Response to pancreatic enzyme replacement therapy
- ✓Evidence of malabsorption through stool studies
- ✓Nutritional assessment showing deficiencies
- ✓Exclusion of other causes of malabsorption
Commonly Confused Codes
K90.9 — Intestinal malabsorption unspecified when cause is not pancreaticE84.19 — Cystic fibrosis when this is the underlying causeK86.0 — Alcohol-induced chronic pancreatitis may be the causeK90.0 — Celiac disease causes malabsorption but not pancreatic insufficiencyZ90.410 — Acquired absence of pancreas post-surgical
Code Hierarchy
└K86Other diseases of pancreas└K86.8Other specified diseases of pancreas└K86.81Exocrine pancreatic insufficiency
└K86.81Exocrine pancreatic insufficiency