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ICD-10 Guide
ICD-10 CodesK76.9

K76.9

Billable

Liver disease, unspecified

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

Code Description

ICD-10 K76.9 is a billable code used to indicate a diagnosis of liver disease, unspecified.

Key Diagnostic Point:

Liver disease, unspecified (K76.9) encompasses a range of hepatic disorders characterized by liver dysfunction without a specific diagnosis. Clinically, patients may present with symptoms such as fatigue, jaundice, abdominal pain, and ascites, which can indicate underlying liver pathology. The liver, a vital organ in the digestive system, plays a crucial role in metabolism, detoxification, and synthesis of proteins. Disease progression can vary widely, from mild dysfunction to severe liver failure, depending on the etiology, which may include viral infections, alcohol abuse, metabolic disorders, or autoimmune conditions. Diagnostic considerations for K76.9 involve a thorough patient history, physical examination, and laboratory tests such as liver function tests, imaging studies, and possibly liver biopsy to rule out specific liver diseases. Due to the broad nature of this code, it is essential for healthcare providers to document any clinical findings and relevant history to support the diagnosis of unspecified liver disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Varies based on the need for differential diagnosis.
  • Treatment complexity: Treatment may range from lifestyle modifications to advanced therapies.
  • Documentation requirements: Requires comprehensive documentation to justify the unspecified diagnosis.
  • Coding specificity: Limited specificity may lead to challenges in capturing the exact nature of the liver disease.

Audit Risk Factors

  • Common coding errors: Misuse of K76.9 when a more specific code is available.
  • Documentation gaps: Incomplete clinical notes that do not support the unspecified diagnosis.
  • Billing challenges: Potential for claim denials if documentation does not adequately justify the use of K76.9.

Specialty Focus

Medical Specialties

Primary medical specialty: 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

Secondary specialty: Internal 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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The clinical significance of K76.9 lies in its representation of a broad spectrum of liver diseases that may affect a significant portion of the population. Understanding and accurately coding liver disease can improve population health outcomes by facilitating appropriate management and treatment. Quality measures related to liver health and healthcare utilization patterns can be influenced by the accurate identification of liver disease, ultimately impacting epidemiological studies and public health initiatives.

ICD-9 vs ICD-10

The clinical significance of K76.9 lies in its representation of a broad spectrum of liver diseases that may affect a significant portion of the population. Understanding and accurately coding liver disease can improve population health outcomes by facilitating appropriate management and treatment. Quality measures related to liver health and healthcare utilization patterns can be influenced by the accurate identification of liver disease, ultimately impacting epidemiological studies and public health initiatives.

Reimbursement & Billing Impact

reimbursement considerations and to ensure compliance with coding best practices to minimize billing challenges.

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 K76.9?

K76.9 covers liver diseases that do not fall under a more specific diagnosis, including but not limited to chronic liver disease, liver dysfunction, and liver conditions of unknown etiology. It is essential to document any clinical findings that may indicate the underlying cause.

When should K76.9 be used instead of related codes?

K76.9 should be used when there is evidence of liver disease but no definitive diagnosis can be made. If a specific liver condition is identified, such as hepatitis or cirrhosis, the corresponding specific code should be utilized.

What documentation supports K76.9?

Documentation should include a detailed patient history, physical examination findings, laboratory results indicating liver dysfunction, and any imaging studies performed. Clear notes on the rationale for using the unspecified code are also crucial.