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ICD-10 Guide
ICD-10 CodesK71.6

K71.6

Billable

Toxic liver disease with hepatitis, not elsewhere classified

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 K71.6 is a billable code used to indicate a diagnosis of toxic liver disease with hepatitis, not elsewhere classified.

Key Diagnostic Point:

Toxic liver disease with hepatitis, not elsewhere classified (K71.6) refers to liver damage resulting from exposure to toxic substances, including drugs, alcohol, and environmental toxins. Clinically, patients may present with symptoms such as jaundice, fatigue, abdominal pain, and elevated liver enzymes. The liver, a vital organ in the digestive system, plays a crucial role in metabolizing substances and detoxifying harmful compounds. Disease progression can vary, with some patients experiencing acute liver injury while others may develop chronic liver disease. Diagnostic considerations include a thorough patient history, laboratory tests to assess liver function, imaging studies, and sometimes liver biopsy to determine the extent of damage. It is essential to differentiate K71.6 from other liver diseases, such as viral hepatitis or alcoholic liver disease, to ensure appropriate management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of liver function and potential toxic exposures.
  • Treatment complexity: Management may involve cessation of exposure, supportive care, and monitoring for complications.
  • Documentation requirements: Detailed documentation of exposure history and clinical findings is crucial.
  • Coding specificity: Requires accurate identification of the toxic agent and exclusion of other liver conditions.

Audit Risk Factors

  • Common coding errors: Misidentification of the toxic agent or failure to document exposure history.
  • Documentation gaps: Incomplete clinical notes regarding patient history and laboratory results.
  • Billing challenges: Potential denials due to lack of specificity in documentation or coding.

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Hepatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

K71.6 has significant clinical implications as toxic liver disease can lead to severe complications, including liver failure and the need for transplantation. Understanding the epidemiology of toxic exposures is crucial for public health initiatives aimed at reducing incidence rates. Quality measures may include monitoring liver function tests and patient outcomes following exposure. Increased awareness of toxic liver disease can lead to improved healthcare utilization patterns and better management strategies for affected populations.

ICD-9 vs ICD-10

K71.6 has significant clinical implications as toxic liver disease can lead to severe complications, including liver failure and the need for transplantation. Understanding the epidemiology of toxic exposures is crucial for public health initiatives aimed at reducing incidence rates. Quality measures may include monitoring liver function tests and patient outcomes following exposure. Increased awareness of toxic liver disease can lead to improved healthcare utilization patterns and better management strategies for affected populations.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is well-supported by clinical evidence and that all relevant tests are documented. Common denials may arise from insufficient documentation linking the toxic exposure to liver disease. Best practices include maintaining thorough records of patient interactions, laboratory results, and treatment plans to facilitate accurate billing and reduce audit risks.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for K00-K99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by K71.6?

K71.6 encompasses liver damage due to various toxic agents, including but not limited to medications (e.g., acetaminophen), industrial chemicals, and herbal supplements. It is crucial to document the specific toxic exposure when coding.

When should K71.6 be used instead of related codes?

K71.6 should be used when the liver disease is specifically due to toxic exposure and not classified under other codes such as viral hepatitis (B15-B19) or alcoholic liver disease (K70). Proper documentation of the toxic agent is essential for accurate coding.

What documentation supports K71.6?

Documentation should include a detailed patient history of potential toxic exposures, clinical symptoms, laboratory results indicating liver function, and any imaging studies performed. A clear link between the toxic exposure and liver damage must be established.