2026 ICD-10-CM Diagnosis Code S36.269SMajor laceration of unspecified part of pancreas, sequela
S36.269S is a billable ICD-10-CM diagnosis code for major laceration of unspecified part of pancreas, sequela. The 7th character S marks it as a sequela code, which reports a problem that remains after the original condition has resolved. It is valid on HIPAA claims for fiscal year 2026 (October 1, 2025 through September 30, 2026) and groups to MS-DRG 393 through 395. The code is exempt from POA reporting. Coders also document this condition as injury to pancreas - open. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Injury, sequela.
Code Identity
Code Classification
Present on Admission (POA)Billing
S36.269S is exempt from POA reporting on inpatient claims to general acute care hospitals. Review other POA exempt codes.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Injury to pancreas - open
- Laceration of pancreas parenchyma
- Tear 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 2026, published by CMS and the National Center for Health Statistics.
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 S36.269S to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About S36.269SOverview
Is S36.269S (Major laceration of unspecified part of pancreas) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report major laceration of unspecified part of pancreas, sequela on HIPAA-covered claims from October 1, 2025 through September 30, 2026.
What does the 7th character S in S36.269S mean?
The final character S makes this a sequela code: it reports a lingering problem that remains after the major laceration of unspecified part of pancreas itself has resolved, not the original event.
What MS-DRG does S36.269S group to?
When major laceration of unspecified part of pancreas, sequela is the principal diagnosis on an inpatient stay, it groups to MS-DRG 393, 394, 395, with relative weights from 0.6490 to 1.5993 depending on complications. Higher weights mean higher Medicare reimbursement.
Is S36.269S exempt from POA reporting?
Yes. CMS lists this code among those exempt from present on admission reporting, so hospitals do not assign a POA indicator for major laceration of unspecified part of pancreas, sequela on inpatient claims.
What is the ICD-9 equivalent of S36.269S?
Under the General Equivalence Mappings, major laceration of unspecified part of pancreas, sequela converts to ICD-9-CM 908.1 (late eff int inj abdomen). The mapping is approximate, so confirm the match fits the documentation.
Footnotes
[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.
