2027 ICD-10-CM Diagnosis Code K86.9Disease of pancreas, unspecified
ICD-10-CM Codes›K00–K95›K80-K87›K86
- Billable — Valid for Submission
- Not Chronic
K86.9 is a billable ICD-10-CM diagnosis code for disease of pancreas, unspecified. 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. Coders also document this condition as cystic fibrosis of pancreas. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Pancreatic disorders (excluding diabetes).
K86.9 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 66 for payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
K86.9 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.
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.
- Cystic fibrosis of pancreas
- Diabetes mellitus associated with pancreatic disease
- Disorder of pancreas
- Exocrine pancreatic manifestation co-occurrent and due to cystic fibrosis
- Impaired glucose tolerance associated with pancreatic disease
- Pancreatic duct disorder
- Panniculitis due to action of lipolytic enzymes
- Panniculitis secondary to pancreatic disease
- Pleural effusion due to another disorder
- Pleural effusion due to disorder of pancreas
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K86.9: 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.
- 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)
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name K86.9, its category, or a range that includes it.
Code First 1
These codes say to code first a condition named in the note, and K86.9 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.
Disease, diseased See Also: Syndrome;
pancreas K86.9
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Pancreatic Diseases
The pancreas is a gland behind your stomach and in front of your spine. It produces juices that help break down food and hormones that help control blood sugar levels. Problems with the pancreas can lead to many health problems. These include:
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K86.9 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K86.9Overview
What is the ICD-10 code for disease of pancreas, unspecified?
The ICD-10-CM code for disease of pancreas, unspecified is K86.9 (sometimes written as K869). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K86.9 (Other diseases of pancreas) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report disease of pancreas, unspecified on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K86.9 group to?
When disease of pancreas, unspecified 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.
What is the ICD-9 equivalent of K86.9?
Under the General Equivalence Mappings, disease of pancreas, unspecified converts to ICD-9-CM 577.9 (pancreatic disease NOS). The mapping is a direct match.
Does K86.9 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: K86.9 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 66 (Pancreatic Disorders and Intestinal Malabsorption, Except Pancreatitis).
