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ICD-10 Guide
ICD-10 CodesK72.10

K72.10

Billable

Chronic hepatic failure without coma

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

Code Description

ICD-10 K72.10 is a billable code used to indicate a diagnosis of chronic hepatic failure without coma.

Key Diagnostic Point:

Chronic hepatic failure without coma, classified under K72.10, refers to the progressive deterioration of liver function due to chronic liver disease, which can result from various etiologies such as viral hepatitis, alcohol-related liver disease, or non-alcoholic fatty liver disease. Clinically, patients may present with symptoms such as fatigue, jaundice, ascites, and easy bruising, reflecting the liver's inability to perform its metabolic and synthetic functions. The liver, anatomically located in the upper right quadrant of the abdomen, plays a crucial role in detoxification, protein synthesis, and the production of biochemicals necessary for digestion. Disease progression can lead to complications like portal hypertension and hepatic encephalopathy, although K72.10 specifically denotes cases without coma. Diagnostic considerations include liver function tests, imaging studies, and possibly liver biopsy to assess the extent of damage. Regular monitoring and evaluation are essential to manage the condition effectively and prevent further complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of liver function and potential underlying causes.
  • Treatment complexity: Management may involve lifestyle changes, medications, and monitoring for complications.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: Requires accurate coding to differentiate from acute hepatic failure and other liver conditions.

Audit Risk Factors

  • Common coding errors: Misclassification with acute liver failure codes.
  • Documentation gaps: Incomplete records regarding the chronicity and severity of liver disease.
  • Billing challenges: Potential denials due to insufficient evidence of chronicity or lack of supporting documentation.

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

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Chronic hepatic failure significantly impacts population health, contributing to increased healthcare utilization and costs due to frequent hospitalizations and management of complications. Quality measures focus on monitoring liver function and managing risk factors to prevent disease progression. Epidemiologically, chronic liver disease is a major public health concern, with rising prevalence linked to lifestyle factors such as obesity and alcohol consumption, necessitating effective public health strategies.

ICD-9 vs ICD-10

Chronic hepatic failure significantly impacts population health, contributing to increased healthcare utilization and costs due to frequent hospitalizations and management of complications. Quality measures focus on monitoring liver function and managing risk factors to prevent disease progression. Epidemiologically, chronic liver disease is a major public health concern, with rising prevalence linked to lifestyle factors such as obesity and alcohol consumption, necessitating effective public health strategies.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the diagnosis is clearly linked to the services provided. Common denials may arise from insufficient documentation of the chronic nature of the disease or failure to demonstrate medical necessity for the services rendered. Best practices include maintaining detailed clinical notes, ensuring accurate coding, and regularly reviewing payer guidelines to avoid 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 K72.10?

K72.10 encompasses chronic liver diseases leading to hepatic failure without coma, including conditions like cirrhosis, chronic hepatitis, and liver fibrosis, where liver function is significantly impaired but does not present with encephalopathy.

When should K72.10 be used instead of related codes?

K72.10 should be used when the patient has chronic hepatic failure without any signs of coma or altered mental status, differentiating it from codes that indicate acute liver failure or chronic hepatic failure with coma.

What documentation supports K72.10?

Documentation should include a thorough history and physical examination, laboratory results indicating liver function impairment, imaging studies, and any relevant treatment plans that demonstrate chronicity and the absence of acute complications.