2027 ICD-10-CM Diagnosis Code S36.200AUnspecified injury of head of pancreas, initial encounter
ICD-10-CM Codes›S00–T88›S30-S39›S36
- Billable — Valid for Submission
- CC — Complication or Comorbidity
- 7th Character A — Initial Encounter
- Not Chronic
S36.200A is a billable ICD-10-CM diagnosis code for unspecified injury of head of pancreas, initial encounter. The 7th character A marks it as an initial encounter code, used while the patient is receiving active treatment. 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, 963 through 965. 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 182 closely related codes. Coders also document this condition as injury of head of pancreas with open wound into abdominal cavity. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Internal organ injury, initial encounter.
Code Identity
Code Classification
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Injury of head of pancreas with open wound into abdominal cavity
- Injury of head of pancreas without open wound into cavity
- Retroperitoneum injury with open wound into cavity
- Traumatic injury of head of pancreas
Coding GuidelinesGuidance
The appropriate 7th character is to be added to each code from block Injury of intra-abdominal organs (S36). Use the following options for the applicable episode of care:
- A - initial encounter
- D - subsequent encounter
- S - sequela
Source: ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, published by CMS and the National Center for Health Statistics.
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to S36.200A: its own notes plus those printed at S36, block S30-S39, and Chapter 19. A note printed at a category, block or chapter applies to every code under it.
Includes
Further defines, or gives examples of, the content of the category.
- injuries to the abdominal wall
- injuries to the anus
- injuries to the buttock
- injuries to the external genitalia
- injuries to the flank
- injuries to the groin
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.
Use Additional Code
Add a second code, after this one, to fully describe the condition.
- code to identify any retained foreign body, if applicable (Z18.-)
Code Also
A second code may be needed to fully describe the condition; the note gives no sequencing direction.
Notes
General instructions on how these codes are used.
- Use secondary code(s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code
- The chapter uses the S-section for coding different types of injuries related to single body regions and the T-section to cover injuries to unspecified body regions as well as poisoning and certain other consequences of external causes.
7th Character
Every code in the category takes a 7th character from the listed values, with the placeholder X filling any empty positions before it.
- The appropriate 7th character is to be added to each code from category S36
- Ainitial encounter this code
- Dsubsequent encounter
- Ssequela
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name S36.200A, its category, or a range that includes it.
Use Additional Code 1
These codes say to use an additional code from the note, and S36.200A is one of the codes named.
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 S36.200A to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S36.200AOverview
What is the ICD-10 code for unspecified injury of head of pancreas, initial encounter?
The ICD-10-CM code for unspecified injury of head of pancreas, initial encounter is S36.200A (sometimes written as S36200A). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is S36.200A (Unspecified injury of head of pancreas) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report unspecified injury of head of pancreas, initial encounter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What does the 7th character A in S36.200A mean?
The final character A marks the initial encounter: use it while the patient is receiving active treatment for unspecified injury of head of pancreas, such as an emergency visit or first evaluation.
What MS-DRG does S36.200A group to?
When unspecified injury of head of pancreas, initial encounter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 964, 965, 440, 438, 439, 963, with relative weights from 0.5966 to 2.6361 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S36.200A a CC or MCC?
CMS lists S36.200A 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 182 closely related codes in its exclusion list.
