ICD-10 · PDGM grouping
K86 Other diseases of pancreas
All 7 codes in the K86 family, with the PDGM clinical group, comorbidity subgroup and primary-position rule CMS assigns, read from the CMS grouper crosswalk v07.2.26 and the CDC FY2027 code file.
Codes in family
7
Can lead a claim
6
Cannot lead a claim
1
What CMS assigns to K86
6 of the 7 codes group to MMTA - Gastrointestinal tract and Genitourinary system; 1 is assigned no clinical group. 2 of the 7 count toward the Pancreatitis, Cholelithiasis and Cholecystitis comorbidity subgroup; 5 are assigned none. 6 of the 7 can lead a claim.
- Pancreatitis, Cholelithiasis and Cholecystitis
Every code in K86
Descriptions are CDC’s FY2027 wording; where CMS’s grouper abbreviates one, its form is shown beneath.
| Code | Description | Primary position | Clinical group | Comorbidity subgroup |
|---|---|---|---|---|
| K86.0 | Alcohol-induced chronic pancreatitis | Can lead a claim | J | Pancreatitis, Cholelithiasis and Cholecystitis |
| K86.1 | Other chronic pancreatitis | Can lead a claim | J | Pancreatitis, Cholelithiasis and Cholecystitis |
| K86.2 | Cyst of pancreas | Can lead a claim | J | None |
| K86.3 | Pseudocyst of pancreas | Can lead a claim | J | None |
| K86.8 Other specified diseases of pancreas | ||||
| K86.81 | Exocrine pancreatic insufficiency | Can lead a claim | J | None |
| K86.89 | Other specified diseases of pancreas | Can lead a claim | J | None |
| K86.9 | Disease of pancreas, unspecified | Cannot lead a claimPrincipal diagnosis not assigned to a clinical group | None | None |
Sources: CMS HH PPS Grouper Software v07.2.26, effective 2026-10-01, for the clinical group, comorbidity subgroup, code-first conventions and primary-position flags; CDC NCHS ICD-10-CM FY2027 code descriptions for the family title and code wording. This is the crosswalk Medicare runs a claim through. Grouping also depends on admission source, timing, the OASIS functional items and the rest of the diagnosis list.
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