K80-K87 — Disorders of gallbladder, biliary tract and pancreas
ICD-10-CM codes K80-K87 cover disorders of gallbladder, biliary tract and pancreas, within diseases of the digestive system. The block holds 112 codes across 7 categories, of which 88 are billable and 24 are header codes that cannot be submitted on a claim.
Risk adjustment in K80-K87
0 codes in this block map to a CMS-HCC, which means the diagnosis carries a risk-adjustment payment when it is documented and coded. Under-coding here is money left on the table; over-coding here is what audits are for.
- HCC 68 Cholangitis and Obstruction of Bile Duct Without Gallstones
- HCC 79 Chronic Pancreatitis
What else to watch in K80-K87
- 88 codes are named in Medicare coverage policies. An LCD or NCD lists them as supporting medical necessity, or explicitly as not supporting it. Which applies depends on the MAC for your state.