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ICD-10 Guide
ICD-10 CodesK72.01

K72.01

Billable

Acute and subacute hepatic failure with coma

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

Code Description

ICD-10 K72.01 is a billable code used to indicate a diagnosis of acute and subacute hepatic failure with coma.

Key Diagnostic Point:

Acute and subacute hepatic failure with coma is a severe condition characterized by the rapid deterioration of liver function, leading to hepatic encephalopathy and altered mental status. The liver, a vital organ responsible for detoxification, protein synthesis, and metabolic regulation, becomes unable to perform its functions due to acute injury or chronic disease exacerbation. Clinical presentation may include jaundice, coagulopathy, and hepatic encephalopathy, which can progress to coma. The disease can be caused by various factors, including viral hepatitis, drug-induced liver injury, or ischemic liver damage. Diagnosis typically involves clinical evaluation, laboratory tests (such as liver function tests), and imaging studies to assess liver structure and function. Early identification and management are crucial to prevent irreversible damage and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation of liver function and potential underlying causes.
  • Treatment complexity: Involves multidisciplinary approaches including critical care, potential liver transplantation, and management of complications.
  • Documentation requirements: Detailed clinical documentation is essential to support the diagnosis and treatment plan.
  • Coding specificity: Requires precise coding to differentiate from other liver conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with less severe liver conditions.
  • Documentation gaps: Incomplete clinical notes regarding the patient's mental status and liver function.
  • Billing challenges: Potential denials due to insufficient evidence of acute hepatic failure and coma.

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

Critical Care Medicine

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

Acute and subacute hepatic failure with coma has significant clinical implications, often leading to high morbidity and mortality rates. It affects a diverse patient population, necessitating intensive healthcare resources. Understanding this condition is crucial for improving quality measures and healthcare utilization patterns, as timely intervention can drastically alter patient outcomes. Epidemiologically, it highlights the need for preventive strategies against liver disease and better management of risk factors.

ICD-9 vs ICD-10

Acute and subacute hepatic failure with coma has significant clinical implications, often leading to high morbidity and mortality rates. It affects a diverse patient population, necessitating intensive healthcare resources. Understanding this condition is crucial for improving quality measures and healthcare utilization patterns, as timely intervention can drastically alter patient outcomes. Epidemiologically, it highlights the need for preventive strategies against liver disease and better management of risk factors.

Reimbursement & Billing Impact

Reimbursement considerations include the severity of the condition and the complexity of care, particularly in critical care settings. Common denials may arise from insufficient documentation of the patient's mental status and liver function. Best practices include ensuring that all clinical notes are thorough and that any procedures performed are clearly linked to the diagnosis to support claims.

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 K72.01?

K72.01 covers acute and subacute hepatic failure characterized by significant liver dysfunction leading to coma. This includes conditions such as fulminant hepatic failure and acute liver failure due to various etiologies, including viral hepatitis, drug toxicity, and metabolic disorders.

When should K72.01 be used instead of related codes?

K72.01 should be used when the patient presents with acute or subacute hepatic failure accompanied by coma. It is crucial to differentiate this from K72.00, which does not include coma, to ensure accurate representation of the severity of the patient's condition.

What documentation supports K72.01?

Documentation for K72.01 should include clinical notes indicating the patient's mental status, laboratory results showing liver function impairment, and evidence of hepatic encephalopathy. Additionally, any imaging studies or consultations that support the diagnosis should be included.