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ICD-10 Guide
ICD-10 CodesK74.60

K74.60

Billable

Unspecified cirrhosis of liver

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

Code Description

ICD-10 K74.60 is a billable code used to indicate a diagnosis of unspecified cirrhosis of liver.

Key Diagnostic Point:

Unspecified cirrhosis of the liver (ICD-10 code K74.60) refers to a chronic liver disease characterized by the replacement of healthy liver tissue with scar tissue, leading to progressive liver dysfunction. The liver, a vital organ in the digestive system, plays a crucial role in metabolism, detoxification, and synthesis of proteins. Cirrhosis can result from various etiologies, including chronic viral hepatitis, alcohol abuse, and non-alcoholic fatty liver disease. Clinically, patients may present with symptoms such as fatigue, jaundice, ascites, and easy bruising. Disease progression can lead to complications like portal hypertension, liver failure, and hepatocellular carcinoma. Diagnosis typically involves a combination of clinical evaluation, laboratory tests (e.g., liver function tests, serologies), imaging studies (ultrasound, CT, or MRI), and sometimes liver biopsy. The unspecified nature of K74.60 indicates that the specific cause of cirrhosis has not been determined, necessitating further investigation to guide management and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough evaluation to determine underlying cause.
  • Treatment complexity: Management may involve lifestyle changes, medications, or liver transplantation.
  • Documentation requirements: Detailed clinical documentation is essential for accurate coding.
  • Coding specificity: Unspecified code may lead to ambiguity in clinical data.

Audit Risk Factors

  • Common coding errors: Misclassification of cirrhosis type.
  • Documentation gaps: Incomplete clinical notes regarding liver function and etiology.
  • Billing challenges: Potential for claim denials due to insufficient documentation.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Unspecified cirrhosis of the liver has significant clinical implications, as it can lead to severe complications and increased healthcare utilization. The prevalence of cirrhosis is rising globally, impacting population health and necessitating effective management strategies. Quality measures for cirrhosis care focus on early detection, management of complications, and patient education. Epidemiologically, cirrhosis is a leading cause of morbidity and mortality, underscoring the importance of accurate coding and documentation to improve patient outcomes and healthcare resource allocation.

ICD-9 vs ICD-10

Unspecified cirrhosis of the liver has significant clinical implications, as it can lead to severe complications and increased healthcare utilization. The prevalence of cirrhosis is rising globally, impacting population health and necessitating effective management strategies. Quality measures for cirrhosis care focus on early detection, management of complications, and patient education. Epidemiologically, cirrhosis is a leading cause of morbidity and mortality, underscoring the importance of accurate coding and documentation to improve patient outcomes and healthcare resource allocation.

Reimbursement & Billing Impact

Reimbursement considerations include the need for thorough clinical documentation that outlines the patient's history, symptoms, and diagnostic findings. Common denials may arise from insufficient documentation or failure to provide evidence of medical necessity. Coders should ensure that all relevant information is captured in the medical record to support the claim and avoid potential audit issues. Best practices include regular training on coding updates and maintaining clear communication with healthcare providers regarding documentation needs.

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 K74.60?

K74.60 encompasses cirrhosis of the liver without a specified cause, which may include cases where the etiology is unknown or not documented. It does not cover cirrhosis due to alcohol, viral hepatitis, or other specified causes.

When should K74.60 be used instead of related codes?

K74.60 should be used when the cause of cirrhosis is not identified or documented. If the etiology is known, such as alcoholic cirrhosis (K74.61) or biliary cirrhosis (K74.62), the corresponding specific code should be selected.

What documentation supports K74.60?

Documentation should include a comprehensive history and physical examination, laboratory results indicating liver dysfunction, imaging studies, and any relevant clinical findings that support the diagnosis of unspecified cirrhosis.