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ICD-10 Guide
ICD-10 CodesK71.11

K71.11

Billable

Toxic liver disease with hepatic necrosis, with coma

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

Code Description

ICD-10 K71.11 is a billable code used to indicate a diagnosis of toxic liver disease with hepatic necrosis, with coma.

Key Diagnostic Point:

Toxic liver disease with hepatic necrosis, with coma (K71.11) is a severe condition resulting from exposure to hepatotoxic substances, leading to significant liver damage and potential liver failure. The liver, a vital organ in the digestive system, is responsible for detoxifying harmful substances, producing bile for digestion, and regulating metabolism. In cases of toxic liver disease, the hepatocytes (liver cells) undergo necrosis, which can progress rapidly, especially in the presence of certain toxins such as acetaminophen, alcohol, or industrial chemicals. Clinical presentation often includes jaundice, abdominal pain, and altered mental status, culminating in coma due to hepatic encephalopathy. Diagnosis typically involves a thorough patient history, liver function tests, imaging studies, and sometimes liver biopsy to assess the extent of necrosis. Early recognition and intervention are crucial to prevent irreversible liver damage and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of liver function and potential toxin exposure.
  • Treatment complexity: May involve hospitalization, supportive care, and potential liver transplantation.
  • Documentation requirements: Detailed clinical documentation is necessary to justify the diagnosis and treatment.
  • Coding specificity: Requires precise coding to differentiate from other liver diseases.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of liver disease.
  • Documentation gaps: Incomplete records regarding toxin exposure or clinical symptoms.
  • Billing challenges: Difficulty in justifying high-level care due to the complexity of the condition.

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

Emergency 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

K71.11 has significant clinical implications, as it represents a critical condition that can lead to high morbidity and mortality rates. The population health impact is substantial, particularly in cases of drug overdose or exposure to toxic substances. Quality measures focus on timely diagnosis and management to prevent complications, while healthcare utilization patterns may show increased hospital admissions and intensive care needs. Epidemiologically, understanding the prevalence of toxic liver disease can guide public health initiatives aimed at reducing exposure to known hepatotoxic agents.

ICD-9 vs ICD-10

K71.11 has significant clinical implications, as it represents a critical condition that can lead to high morbidity and mortality rates. The population health impact is substantial, particularly in cases of drug overdose or exposure to toxic substances. Quality measures focus on timely diagnosis and management to prevent complications, while healthcare utilization patterns may show increased hospital admissions and intensive care needs. Epidemiologically, understanding the prevalence of toxic liver disease can guide public health initiatives aimed at reducing exposure to known hepatotoxic agents.

Reimbursement & Billing Impact

Reimbursement may be impacted by the severity of the condition and the complexity of care provided. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for intensive care services. It is essential to follow coding best practices and ensure that the coding accurately reflects the patient's clinical status to avoid 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 K71.11?

K71.11 covers toxic liver disease characterized by hepatic necrosis and coma, primarily due to exposure to hepatotoxic agents such as drugs, alcohol, or chemicals. It includes cases where liver function is severely impaired, leading to altered mental status.

When should K71.11 be used instead of related codes?

K71.11 should be used when there is clear evidence of hepatic necrosis accompanied by coma. If the patient presents with liver toxicity without coma, K71.0 would be more appropriate.

What documentation supports K71.11?

Documentation should include a detailed patient history of toxin exposure, clinical findings indicating hepatic necrosis, laboratory results showing liver function impairment, and evidence of altered mental status or coma.