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ICD-10 Coding for History of Pancreatitis(Z86.81)

Complete ICD-10-CM coding and documentation guide for History of Pancreatitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Past PancreatitisResolved Pancreatitis

Related ICD-10 Code Ranges

Complete code families applicable to History of Pancreatitis

Z86.81Primary Range

Personal history of diseases of the digestive system

Used for documenting resolved cases of pancreatitis that no longer impact current care.

Acute and chronic pancreatitis

Used for active cases of pancreatitis, both acute and chronic.

Key Information: ICD-10 code for history of pancreatitis

Essential facts and insights about History of Pancreatitis

The ICD-10 code for a history of pancreatitis is Z86.81, used when the condition is resolved.

Primary ICD-10-CM Code for history of pancreatitis

Personal history of diseases of the digestive system
Non-billable Code

Decision Criteria

clinical Criteria

  • Patient has no current symptoms or treatment related to pancreatitis.

documentation Criteria

  • Medical record includes 'history of pancreatitis' with resolved status.

Applicable To

  • History of resolved pancreatitis

Excludes

Clinical Validation Requirements

  • Documentation stating 'history of pancreatitis'
  • No current symptoms or treatment for pancreatitis

Code-Specific Risks

  • Incorrectly using for active chronic pancreatitis

Coding Notes

  • Ensure documentation clearly states 'history of' to avoid confusion with active conditions.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Personal history of nicotine dependence

Z87.891
Use if the history of pancreatitis was related to past nicotine use.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Acute pancreatitis, unspecified

K85.9
Use K85.9 for active acute pancreatitis with current symptoms.

Other chronic pancreatitis

K86.1
Use K86.1 for ongoing chronic pancreatitis requiring treatment.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting History of Pancreatitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code Z86.81.

Impact

Clinical: May lead to inappropriate treatment decisions., Regulatory: Could result in audit findings., Financial: Potential for incorrect billing and reimbursement.

Mitigation Strategy

Use templates for documenting resolved conditions, Regular training on documentation standards

Impact

Reimbursement: Incorrect coding may lead to underpayment., Compliance: May result in compliance issues during audits., Data Quality: Affects the accuracy of patient records.

Mitigation Strategy

Use K86.1 for chronic pancreatitis that is still active.

Impact

Using history codes for active conditions can lead to audit issues.

Mitigation Strategy

Ensure thorough documentation of condition status.

Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.

Frequently Asked Questions

Common questions about ICD-10 coding for History of Pancreatitis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for History of Pancreatitis

Use these documentation templates to ensure complete and accurate documentation for History of Pancreatitis. These templates include all required elements for proper coding and billing.

Resolved pancreatitis documentation

Specialty: Gastroenterology

Required Elements

  • Past medical history
  • Resolution status
  • No current symptoms

Example Documentation

Patient has a history of pancreatitis resolved in 2019 with no current symptoms or treatment.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Pancreatitis in past.
Good Documentation Example
History of pancreatitis resolved in 2019, no current symptoms.
Explanation
The good example specifies resolution and lack of current symptoms, supporting the use of Z86.81.

Need help with ICD-10 coding for History of Pancreatitis? Ask your questions below.

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