2027 ICD-10-CM Diagnosis Code K86.0Alcohol-induced chronic pancreatitis
ICD-10-CM Codes›K00–K95›K80-K87›K86
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- Risk Adjusts — HCC 79
- Chronic Condition
K86.0 is a billable ICD-10-CM diagnosis code for alcohol-induced chronic pancreatitis. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 438 through 440. As a secondary diagnosis, it counts as a complication or comorbidity (CC) and moves an inpatient stay to a higher severity level within its MS-DRG family. It does not count, however, when the principal diagnosis is one of 27 closely related codes. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pancreatic disorders (excluding diabetes).
For Medicare Advantage risk adjustment, K86.0 maps to CMS-HCC Category 79 (Chronic Pancreatitis) under the V28 model, adding a risk factor of about 0.357 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
K86.0 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Alcohol-induced chronic pancreatitis
- Alcohol-induced pancreatitis
- Chronic pancreatitis due to acute alcohol intoxication
- Chronic pancreatitis due to chronic alcoholism
- Drug-induced chronic pancreatitis
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K86.0: its own notes plus those printed at K86 and Chapter 11. A note printed at a category, block or chapter applies to every code under it.
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- alcohol induced acute pancreatitis (K85.2-)
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify:
- alcohol abuse and dependence (F10.-)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
- exocrine pancreatic insufficiency (K86.81)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name K86.0, its category, or a range that includes it.
Excludes2 1
These codes carry an Excludes2 note naming K86.0: its condition is not part of those codes, and both may be reported when the patient has both.
- K85.2 Alcohol induced acute pancreatitisalcohol induced chronic pancreatitis (K86.0)
Code First 1
These codes say to code first a condition named in the note, and K86.0 is one of the conditions named.
- E08 Diabetes mellitus due to underlying condition
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Alcohol Use Disorder (AUD)
For most adults, moderate alcohol use is probably not harmful. Your risk of developing an alcohol use disorder (AUD) depends on how much, how often, and how quickly you drink alcohol. Alcohol misuse means that drinking causes distress and harm. Over time alcohol misuse can increase your risk of AUD.
The full article covers:
- What is alcohol use disorder (AUD)?
- What is binge drinking?
- What are the dangers of too much alcohol?
- How do I know if I have an alcohol use disorder (AUD)?
- What should I do if I think that I might have an alcohol use disorder (AUD)?
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K86.0 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K86.0Overview
What is the ICD-10 code for alcohol-induced chronic pancreatitis?
The ICD-10-CM code for alcohol-induced chronic pancreatitis is K86.0 (sometimes written as K860). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K86.0 (Other diseases of pancreas) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report alcohol-induced chronic pancreatitis on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K86.0 group to?
When alcohol-induced chronic pancreatitis is the principal diagnosis on an inpatient stay, it groups to MS-DRG 440, 438, 439, with relative weights from 0.5966 to 1.5763 depending on complications. Higher weights mean higher Medicare reimbursement.
Is K86.0 a CC or MCC?
CMS lists K86.0 as a CC (complication or comorbidity) for FY 2027. Reported as a secondary diagnosis, it moves the inpatient stay to a higher-weighted DRG within its severity family. It does not count when the principal diagnosis is one of the 27 closely related codes in its exclusion list.
Does K86.0 need an additional code?
When the condition applies, yes. The Use Additional Code note reads: code to identify: alcohol abuse and dependence (F10.-). The additional code is reported after K86.0.
What HCC is K86.0?
K86.0 (alcohol-induced chronic pancreatitis) maps to CMS-HCC Category 79 (Chronic Pancreatitis), commonly written as HCC 79, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 34 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. In the Part D prescription drug model it maps to RxHCC 65.
Does K86.0 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, K86.0 adds a risk adjustment factor of about 0.357 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.218 to 0.799 depending on the payment segment). HCC 79 sits at the top of its hierarchy, so no other condition category supersedes it. See the full factor table on the HCC 79 category page.
