ICD-10 Guide

A06.6

Amebic liver abscess

BILLABLE STATUSYes

IMPLEMENTATION DATEOctober 1, 2015

LAST UPDATED09/04/2025

Code Description

ICD-10 A06.6 is a billable code used to indicate a diagnosis of amebic liver abscess.

Key Diagnostic Point:

A06.6 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

# Analysis of ICD-10 Code A06.6 - Amebic Liver Abscess ## Complexity Rating: **Medium** ## Factors Contributing to Complexity: 1. **Clinical Presentation**: - Amebic liver abscess can present with nonspecific symptoms such as fever, abdominal pain, and malaise, making it challenging to diagnose without appropriate imaging or laboratory testing. - Differential diagnoses may include conditions such as bacterial liver abscess, which can complicate the clinical picture. 2. **Diagnostic Criteria**: - Diagnosis typically requires serological testing for Entamoeba histolytica, imaging studies (e.g., ultrasound or CT scan), and sometimes liver biopsy. - The need for multiple diagnostic modalities increases complexity as clinicians must coordinate and interpret various results. 3. **Management and Treatment**: - Treatment often involves anti-parasitic medications (e.g., metronidazole or tinidazole), which must be carefully monitored for efficacy and adverse effects. - Management may also require surgical intervention in severe cases, further complicating the clinical pathway. 4. **Epidemiology**: - The prevalence of amebic liver abscess varies geographically, with higher incidence in tropical and subtropical regions, which may affect patient population and access to care. 5. **Comorbidities**: - Patients may present with other health issues, such as HIV/AIDS or liver cirrhosis, which can complicate both diagnosis and treatment strategies. ## Audit Risks and Considerations: 1. **Clinical Documentation**: - Inadequate documentation of symptoms, diagnostic tests, and treatment plans may lead to coding errors or undercoding, resulting in potential revenue loss or audit discrepancies. - Auditors may scrutinize the medical record for clarity regarding the diagnosis, treatment rationale, and follow-up care. 2. **Misdiagnosis**: - There is a risk of misdiagnosing amebic liver abscess as other types of liver abscesses, leading to incorrect coding and potential compliance issues. - Coders must ensure that the condition is accurately documented as amebic rather than bacterial or other abscess types. 3. **Quality of Care Metrics**: - Failure to adhere to clinical guidelines for diagnosis and treatment may impact quality measures and reimbursements, especially in value-based care models. ## Documentation Requirements: 1. **Clinical History**: - A thorough patient history including travel history, exposure to contaminated food or water, and previous gastrointestinal issues is essential for establishing the risk of amebic infection. 2. **Physical Examination**: - Detailed documentation of physical exam findings, particularly any signs of hepatic dysfunction or systemic illness, is required. 3. **Diagnostic Tests**: - Clear documentation of all diagnostic tests performed, including serologies, imaging studies, and any microbiological cultures, must be included in the medical record. 4. **Treatment Plan**: - The treatment plan should be well-documented, including medications prescribed, dosages, duration, and any surgical interventions performed. 5. **Follow-Up**: - Documentation of follow-up visits, response to treatment, and any complications that arise during management is critical for both clinical care and coding accuracy. ## Conclusion: ICD-10 code A06.6 for amebic liver abscess presents a medium level of complexity due to the nuances of clinical presentation, diagnostic requirements, and management strategies. Proper documentation and awareness of audit risks are essential for accurate coding and optimal patient care.

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Standard requirements apply

Common Clinical Scenarios

Various clinical presentations

Billing Considerations

Follow standard billing guidelines

Coding Guidelines

Inclusion Criteria

Use A06.6 When

10 Code A06
Amebic Liver Abscess: Comprehensive Coding Guidelines
Overview
6 is the ICD
10 code for "Amebic liver abscess," a condition resulting from the infection of the liver by the parasite Entamoeba histolytica
This condition typically arises from intestinal amoebiasis and can lead to significant morbidity if not treated promptly
When to Use A06
Related Codes

Exclusion Criteria

Do NOT use A06.6 When

Inclusion and Exclusion Criteria
Exclusion Criteria:
Coders must ensure specificity, adherence to inclusion/exclusion criteria, and careful consideration of related conditions to avoid common coding pitfalls

Related CPT Codes

No CPT Codes Available

Related CPT codes for this diagnosis will be displayed here when available.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Impact of ICD-10 Implementation on Code A06.6 - Amebic Liver Abscess

The transition from ICD-9 to ICD-10 brought significant changes in coding practices, particularly concerning the coding of conditions like amebic liver abscess (code A06.6 in ICD-10). Below is a comprehensive overview of the impact of this implementation.

1. Changes from ICD-9 to ICD-10

ICD-9 vs ICD-10

Impact of ICD-10 Implementation on Code A06.6 - Amebic Liver Abscess The transition from ICD-9 to ICD-10 brought significant changes in coding practices, particularly concerning the coding of conditions like amebic liver abscess (code A06.6 in ICD-10). Below is a comprehensive overview of the impact of this implementation. 1. Changes from ICD-9 to ICD-10 In ICD-9, the coding for amebic liver abscess was represented by a less specific code (e.g., 006.1). This code provided limited detail about the condition, focusing mainly on the presence of the abscess without incorporating factors such as the severity or the underlying cause. In contrast, ICD-10 introduced the code A06.6, which provides a more precise classification of amebic liver abscess. This change allows for better data collection and analysis, contributing to improved public health reporting and epidemiological studies. 2. Specificity Improvements ICD-10 codes are designed with greater specificity compared to ICD-9 codes. Code A06.6 allows...

A06.6

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions

A06.6

Code Description

Key Diagnostic Point:

Code Complexity Analysis

Complexity Rating: Medium

Complexity Factors

Audit Risk Factors

Specialty Focus

Medical Specialties

General

Documentation Requirements

Common Clinical Scenarios

Billing Considerations

Coding Guidelines

Inclusion Criteria

Exclusion Criteria

Related CPT Codes

No CPT Codes Available

ICD-10 Impact

Diagnostic & Documentation Impact

ICD-10 Improvements

ICD-9 vs ICD-10

Reimbursement & Billing Impact

Resources

Clinical References

Coding & Billing References

Frequently Asked Questions