EPI is largely a clinical diagnosis
Look for signs and symptoms and have an open discussion with patients
Patients may present with signs and symptoms similar to those of other GI conditions.2 Any one or combination of the following symptoms could mean EPI3:
Abdominal pain
Bloating
Flatulence
Unexplained weight loss
Steatorrhea*
It’s important to discuss the frequency and severity of symptoms and assess clinical features, such as symptom onset and stool quality.4
Consider underlying conditions and surgical procedures
Remember to discuss underlying conditions and procedures that can lead to EPI2,5-11:
- Chronic pancreatitis
- Cystic fibrosis
- Pancreatectomy
- Pancreatic cancer
Other underlying conditions and procedures in which EPI has been reported include12-16:
- Acute pancreatitis
- Celiac disease
- Crohn’s disease
- Gastric resection/bypass
- Type 1 diabetes
- Type 2 diabetes
Monitor patients with underlying conditions and procedures for symptoms that can indicate EPI.4
Testing can help confirm a clinical diagnosis
- Tests such as fecal elastase-1 (FE-1), qualitative fecal fat analysis, or quantitative fecal fat analysis can help confirm an EPI diagnosis17
- Despite available tests, EPI is largely a clinical diagnosis18
- There is no single convenient, sensitive, and specific diagnostic test for EPI17,19
Code directly for EPI using ICD-10 code K86.8120
Benefits of using ICD-10 code include:
- Coding directly for EPI20
- Measuring patient outcomes21
- Increasing efficiency in the exchange of clinical information21
- Improving diagnostic and epidemiologic data available21
ICD-10 code
K86.81
Review insights that shed light on some of the difficulties associated with diagnosing EPI.
*Steatorrhea: ≥7 g of fecal fat per day while consuming 100 g of dietary fat per day in the context of a 72-hour stool test.18
EPI = exocrine pancreatic insufficiency.