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ICD-10 Guide
ICD-10 CodesK74.69

K74.69

Billable

Other cirrhosis of liver

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

Code Description

ICD-10 K74.69 is a billable code used to indicate a diagnosis of other cirrhosis of liver.

Key Diagnostic Point:

K74.69 refers to 'Other cirrhosis of liver,' which encompasses various forms of liver cirrhosis that do not fall under the more commonly classified types such as alcoholic or viral cirrhosis. Clinically, cirrhosis is characterized by the progressive replacement of healthy liver tissue with scar tissue, leading to impaired liver function. The liver, a vital organ in the digestive system, plays a crucial role in metabolism, detoxification, and the synthesis of proteins. As cirrhosis progresses, patients may experience symptoms such as fatigue, jaundice, ascites, and hepatic encephalopathy. The disease can be caused by a variety of factors including autoimmune diseases, metabolic disorders, and chronic exposure to toxins. Diagnostic considerations include imaging studies (ultrasound, CT, MRI) and liver biopsy to assess the extent of fibrosis and rule out other liver diseases. Regular monitoring and management are essential to prevent complications such as liver failure and hepatocellular carcinoma.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Cirrhosis of the liver, including cases classified under K74.69, has significant clinical implications, affecting a substantial portion of the population with chronic liver disease. Its management is critical for improving patient outcomes and reducing healthcare utilization. Epidemiologically, cirrhosis is associated with increased morbidity and mortality, necessitating effective quality measures and interventions to address its complications and enhance patient care.

ICD-9 vs ICD-10

Cirrhosis of the liver, including cases classified under K74.69, has significant clinical implications, affecting a substantial portion of the population with chronic liver disease. Its management is critical for improving patient outcomes and reducing healthcare utilization. Epidemiologically, cirrhosis is associated with increased morbidity and mortality, necessitating effective quality measures and interventions to address its complications and enhance patient care.

Reimbursement & Billing Impact

Reimbursement considerations include the complexity of the condition and the necessity for ongoing management. Common denials may arise from insufficient documentation or lack of medical necessity. Coders should ensure that all relevant clinical information is included in the medical record to support the diagnosis and any related services provided. Best practices include regular audits of documentation and coding accuracy to minimize billing issues.

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 K74.69?

K74.69 covers cirrhosis resulting from various etiologies not specified elsewhere, including but not limited to biliary cirrhosis, metabolic liver diseases, and drug-induced liver injury. It is essential to document the underlying cause when available.

When should K74.69 be used instead of related codes?

K74.69 should be used when the cirrhosis is not classified under other specific codes such as K74.60 or K74.61. It is crucial to differentiate based on the underlying cause and clinical presentation.

What documentation supports K74.69?

Documentation should include clinical findings, imaging results, laboratory tests, and any relevant history of liver disease or risk factors. A clear diagnosis from a healthcare provider is essential for accurate coding.