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Chronic Pancreatitis J015

Document
Last amended 
28 June 2015

Current RMA Instruments:

Reasonable Hypothesis SOP
104 of 2011
Balance of Probabilities SOP
105 of 2011
Changes from Previous Instruments:

SOP Bulletin 153

 ICD Coding:
  • ICD-9-CM Codes:  577.1, 577.8
  • ICD-10-AM Codes: K86.0, K86.1
Is specific diagnostic evidence required to apply the SOP?No.
Are there sub-factors that require specific information? – No. 
Additional diagnoses covered by SOP
  • Acute on chronic pancreatitis
Conditions not covered by SOP
  • Acute pancreatitis, ICD code 577.0
  • Pancreatic cyst, ICD code 577.2
  • Pancreatic pseudocyst, ICD code 577.2
  • Recurrent acute pancreatitis, ICD code 577.0
Unconfirmed diagnosis

If, after applying the above information, you are unable to confirm the diagnosis, you should then:

  • seek medical officer advice about further investigation, or;
  • generate a diagnostic report, or;
  • re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • Report from a physician or gastroenterologist
  • Abdominal X-ray or CT scan showing calcification in the pancreas.