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ICD-10 Guide
ICD-10 CodesK75.3

K75.3

Billable

Granulomatous hepatitis, not elsewhere classified

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

Code Description

ICD-10 K75.3 is a billable code used to indicate a diagnosis of granulomatous hepatitis, not elsewhere classified.

Key Diagnostic Point:

Granulomatous hepatitis is a rare form of liver inflammation characterized by the presence of granulomas, which are small clusters of immune cells that form in response to chronic inflammation. Clinically, patients may present with nonspecific symptoms such as fatigue, malaise, jaundice, and abdominal discomfort. The liver, primarily involved in this condition, may show signs of hepatomegaly upon physical examination. The disease progression can vary; some patients may experience a self-limiting course, while others may develop chronic liver disease or cirrhosis if the underlying cause is not addressed. Diagnostic considerations include liver function tests, imaging studies such as ultrasound or CT scans, and liver biopsy, which is crucial for confirming the diagnosis by revealing granulomatous inflammation. Common etiologies include infections (e.g., tuberculosis, viral hepatitis), autoimmune diseases, and certain medications. Identifying the underlying cause is essential for effective management and treatment planning.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires thorough investigation to identify the underlying cause of granulomatous inflammation.
  • Treatment complexity: Management may involve addressing the underlying condition, which can vary widely.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires accurate coding to differentiate from other forms of hepatitis.

Audit Risk Factors

  • Common coding errors: Misclassification with other hepatitis codes.
  • Documentation gaps: Incomplete clinical history or lack of biopsy results.
  • Billing challenges: Difficulty in justifying the need for advanced imaging or biopsy in some cases.

Specialty Focus

Medical Specialties

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

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

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

Granulomatous hepatitis, while rare, can significantly impact patient health if not diagnosed and treated appropriately. It may lead to chronic liver disease, affecting population health and healthcare utilization patterns. Understanding the epidemiology of this condition is essential for developing quality measures and improving patient outcomes, particularly in populations at risk for autoimmune diseases or infections.

ICD-9 vs ICD-10

Granulomatous hepatitis, while rare, can significantly impact patient health if not diagnosed and treated appropriately. It may lead to chronic liver disease, affecting population health and healthcare utilization patterns. Understanding the epidemiology of this condition is essential for developing quality measures and improving patient outcomes, particularly in populations at risk for autoimmune diseases or infections.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity of the tests performed and the clinical rationale for the diagnosis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for advanced imaging. Best practices include ensuring that all clinical findings and treatment plans are well-documented and that coding accurately reflects the complexity of the condition.

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 K75.3?

K75.3 encompasses granulomatous hepatitis not classified elsewhere, including cases related to infections (like tuberculosis), autoimmune disorders (such as primary biliary cholangitis), and drug-induced liver injury. It is essential to identify the underlying cause for appropriate management.

When should K75.3 be used instead of related codes?

K75.3 should be used when granulomatous hepatitis is diagnosed without a specific classification under other codes. It is important to differentiate it from other hepatitis types by confirming the presence of granulomas through biopsy and ruling out other causes.

What documentation supports K75.3?

Documentation should include clinical findings, laboratory results, imaging studies, and biopsy reports confirming granulomatous inflammation. A thorough history of potential exposures, medications, and associated conditions is also critical.