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ICD-10 Guide
ICD-10 CodesB19.21

B19.21

Unspecified viral hepatitis C with hepatic coma

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 B19.21 is a billable code used to indicate a diagnosis of unspecified viral hepatitis c with hepatic coma.

Key Diagnostic Point:

Unspecified viral hepatitis C with hepatic coma refers to a severe liver condition caused by the hepatitis C virus (HCV), leading to significant liver dysfunction and potentially resulting in hepatic coma. Hepatitis C is primarily transmitted through blood-to-blood contact, often via sharing needles, unsterilized medical equipment, or through transfusions prior to the implementation of blood screening. Chronic hepatitis C can lead to progressive liver disease, including cirrhosis and hepatocellular carcinoma. The hepatic coma, or hepatic encephalopathy, occurs when the liver fails to detoxify harmful substances, leading to a buildup of toxins in the bloodstream that affect brain function. Symptoms may include confusion, altered consciousness, and coma. Management of this condition requires a multidisciplinary approach, including antiviral therapy, supportive care, and monitoring for complications such as variceal bleeding and liver failure. Early diagnosis and treatment are crucial to prevent progression to more severe liver disease.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of viral hepatitis transmission and complications.
  • Differentiation from other types of hepatitis codes.
  • Need for precise documentation of hepatic coma symptoms.
  • Management of chronic conditions and associated complications.

Audit Risk Factors

  • Inadequate documentation of hepatic coma symptoms.
  • Failure to document the specific type of hepatitis C.
  • Lack of evidence for chronic management plans.
  • Misclassification of the severity of liver disease.

Specialty Focus

Medical Specialties

Hepatology

Documentation Requirements

Detailed liver function tests, imaging studies, and treatment plans.

Common Clinical Scenarios

Management of chronic hepatitis C, evaluation of liver function, and treatment of hepatic encephalopathy.

Billing Considerations

Ensure documentation reflects the severity of liver disease and any complications.

Infectious Disease

Documentation Requirements

History of exposure, laboratory confirmation of HCV, and treatment response.

Common Clinical Scenarios

Diagnosis and management of hepatitis C infections, including acute and chronic cases.

Billing Considerations

Document any co-infections and their impact on treatment.

Coding Guidelines

Inclusion Criteria

Use B19.21 When
  • Follow ICD
  • CM guidelines for coding hepatitis, ensuring accurate documentation of the type and severity of hepatitis
  • Include any relevant complications such as hepatic coma
  • Ensure that the code reflects the most specific diagnosis available

Exclusion Criteria

Do NOT use B19.21 When
No specific exclusions found.

Related CPT Codes

86803CPT Code

HCV antibody test

Clinical Scenario

Used for initial diagnosis of hepatitis C.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Ensure the test is linked to the diagnosis of hepatitis C.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hepatitis C and its complications, improving data accuracy and enhancing the ability to track disease prevalence and outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hepatitis C and its complications, improving data accuracy and enhancing the ability to track disease prevalence and outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hepatitis C and its complications, improving data accuracy and enhancing the ability to track disease prevalence and outcomes.

Resources

Clinical References

  • •
    CDC Hepatitis C Information

Coding & Billing References

  • •
    CDC Hepatitis C Information

Frequently Asked Questions

What is the primary cause of hepatic coma in patients with hepatitis C?

Hepatic coma in patients with hepatitis C is primarily caused by liver failure, which leads to the accumulation of toxins in the bloodstream that affect brain function.