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577.8 would be more appropriate gall stone pancreatitis and Pancreatolithiasis share/simulate in many ways clinical manifestations.
 
I would code the pancreatitis followed by the gallstones, (Ex. 577.0 & 574.50) using the appropriate codes for Dx (acute, chronic, ect.).
 
How would we assume it is acute/subacute or chronic while it is not documented there.
Moreove,r the diagnosis is gallstone pancreatitis, which is a calculus condition in the pancreas more related to Pancreatolithiasis - both these conditions are assigned with 577.8

574.5x is not for PANCREATIC CALCULUS. THE BILE DUCTS IS NOT A PART OF PANCREAS ;IT IS TO THE GALL BLADDER AND THE BILIARY SYSTEM

It is upto you, the originator of the thread to take it, or clarify with your physician or leave it. I just try to help to bring the facts to the surface.
Thank you,anyway
 
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arizona1 said:
thank you everyone, I was leaning toward 577.8
Click to expand...

I know this was awhile ago, but i tried to find the right code too..hope this would help

Check the coding clinic Third Quarter and see some questions regarding gallstone pancreatitis.
See some details:
The correct code assignment depends on the individual record documentation related to the gallstone pancreatitis. The original case generating the question published in Coding Clinic, Third Quarter 1994, p.11, referred to an incident with a gallstone in the bile duct with obstruction and chronic pancreatitis. Also, in this particular case, the reason for the admission was the chronic pancreatitis and therefore, code 577.1 was sequenced first.

The correct coding and sequencing of gallstone pancreatitis depends on the location of the gallstone and the reason for treatment. Assign the appropriate code from category 574, Cholelithiasis. Review the record and query the physician regarding the pancreatitis. Assign code 577.0 for acute pancreatitis, or 577.1 for chronic pancreatitis:)

if you have 3M code finder you find the path towards the right code
 
"Gall stone pancreatitis" is a condition causing acute pancreatitis and it occurs when ONE OF THE PANCREATIC DUCTS, becomes BLOCKED BY GALL STONE. This blockage prevents the PANCREAS FROM EXCRETING digestive enzymes as it should. This condition requires medical treatment to prevent serious potential life-threatening complications.

It is an one entity of a disease of the Pancreas alone, which is depicted here( the pancreatic duct is a intra-pancreatic structure, (if you could refresh your anatomy), of the pancreatic head, neck and body of pancreas and it does not mention the diseased status of bile duct per se now at this point.
It causes acute pancreatitis. Acute pancreatitis is the sudden onset of pancreatic inflammation, which may be triggered by a gallstone. Acute pancreatitis may occur only once in a lifetime or multiple times.
So it deserves the category code 577.x with a calculus in the pancreas. And hence the 577.8 is the appropriate code for this unique condition. I would go for Other specified diseases of the pancreas-577.8 – it well fits into calculus of pancreas( calculus in the duct of the pancreas and the duct is intrapancreatic in position and is a structure of the pancreas.

I hope that you would agree with this .
Thank you
 
Considering many physicians perform a cholecystectomy when this condition does not resolve, it is obvious that the pancreatitis is secondary to the gallstones (within the gallbladder...not a calculus of the pancreas).

The pancreatic duct actually stems from the common bile duct. The pancreas is considered both part of the digestive and endocrine systems.

I agree that both conditions should be coded. I would code according to the manifestation convention that requires the underlying condition be coded first (i.e. 574.20, 577.0--the gallstones caused the pancreatitis).
 
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