2026 ICD-10-CM Diagnosis Code K87Disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere
ICD-10-CM Codes›K00–K95›K80-K87›K87
- Billable — Valid for Submission
- Not Chronic
K87 is a billable ICD-10-CM diagnosis code for disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 444 through 446. The code is a manifestation code that cannot be reported as the principal diagnosis. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Biliary tract disease.
K87 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 2026.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for K87.
Medicare Risk Adjustment (HCC)Billing
K87 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 2026 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.
Tabular List NotesGuidance
Coding notes and annotation back-references applicable to this code.
Code First
- underlying disease
Type 1 Excludes
- cytomegaloviral pancreatitis B25.2
- mumps pancreatitis B26.3
- syphilitic gallbladder A52.74
- syphilitic pancreas A52.74
- tuberculosis of gallbladder A18.83
- tuberculosis of pancreas A18.83
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
A type 1 excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Disorder (of) See Also: Disease;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Patient EducationClinical
Bile Duct Diseases
Your liver makes a digestive juice called bile. Your gallbladder stores it between meals. When you eat, your gallbladder pushes the bile into tubes called bile ducts. They carry the bile to your small intestine. The bile helps break down fat. It also helps the liver get rid of toxins and wastes.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K87 to ICD-9-CMHistory
Code HistoryHistory
Questions About K87Overview
Is K87 a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What MS-DRG does K87 group to?
On inpatient claims, disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere maps to MS-DRG 444, 445, 446, with relative weights from 0.8273 to 1.6709 depending on complications. Higher weights mean higher Medicare reimbursement.
Can K87 be a principal diagnosis?
No. This is a manifestation code: disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere describes the manifestation of an underlying disease rather than the disease itself, so the underlying condition is sequenced first.
What is the ICD-9 equivalent of K87?
Under the General Equivalence Mappings, disorders of gallbladder, biliary tract and pancreas in diseases classified elsewhere converts to ICD-9-CM 576.8 (dis of biliary tract NEC) and 577.8 (pancreatic disease NEC). The mapping is approximate, so confirm the match fits the documentation.
Does K87 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: K87 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).
