ICD Code K85.90

ICD code K85.90 is used to identify a diagnosis of acute pancreatitis where there is no evidence of necrosis (tissue death) or infection, and the specific cause or type is not further specified. This code helps healthcare providers document and communicate the condition for treatment and billing purposes.

1. Sudden Onset of Abdominal Pain: The patient experiences a sudden and severe pain in the upper abdomen, which may radiate to the back. This pain is often a key indicator of acute pancreatitis.

2. Elevated Serum Amylase and Lipase Levels: Laboratory tests reveal significantly elevated levels of pancreatic enzymes, such as amylase and lipase, which are indicative of pancreatic inflammation.

3. Nausea and Vomiting: The patient reports persistent nausea and frequent vomiting, which are common symptoms associated with acute pancreatitis.

4. Abdominal Tenderness: Upon physical examination, there is noticeable tenderness in the upper abdominal region, often accompanied by guarding or rigidity.

5. Fever: The patient may present with a mild to moderate fever, which can be a response to the inflammatory process occurring in the pancreas.

6. Tachycardia: An increased heart rate, or tachycardia, may be observed, often as a physiological response to pain or inflammation.

7. Imaging Findings: Imaging studies, such as an abdominal ultrasound or CT scan, show evidence of pancreatic inflammation without signs of necrosis or infection.

8. Absence of Necrosis or Infection: Diagnostic imaging and laboratory tests confirm that there is no necrosis or infection present in the pancreas, distinguishing this condition from more severe forms of pancreatitis.

9. Exclusion of Other Causes: Other potential causes of the symptoms, such as gallstones or alcohol abuse, have been considered and ruled out, supporting the diagnosis of acute pancreatitis without necrosis or infection.

For the ICD code K85.90, which pertains to acute pancreatitis without necrosis or infection, unspecified, the relevant CPT codes that may be applicable include:

1. CPT 43260 - Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure).

2. CPT 43261 - ERCP with biopsy, single or multiple.

3. CPT 43262 - ERCP with sphincterotomy/papillotomy.

4. CPT 43263 - ERCP with removal of foreign body or stent.

5. CPT 43264 - ERCP with endoscopic retrograde removal of stone(s) from biliary/pancreatic duct(s).

6. CPT 43265 - ERCP with destruction of calculi, any method (e.g., mechanical, electrohydraulic, lithotripsy).

7. CPT 43266 - ERCP with dilation of biliary/pancreatic duct(s) strictures(s) with or without placement of stent.

8. CPT 43267 - ERCP with insertion of tube or stent into bile or pancreatic duct.

9. CPT 43268 - ERCP with endoscopic retrograde insertion of nasobiliary or nasopancreatic drainage tube.

10. CPT 43269 - ERCP with endoscopic ultrasound (EUS) for diagnostic purposes.

These CPT codes are typically used for procedures that may be performed in the context of diagnosing or managing conditions related to acute pancreatitis. It is important for healthcare providers to select the appropriate CPT code based on the specific procedure performed and the clinical scenario.

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