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ICD-10 Guide
ICD-10 CodesK72.90

K72.90

Billable

Hepatic failure, unspecified without coma

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

Code Description

ICD-10 K72.90 is a billable code used to indicate a diagnosis of hepatic failure, unspecified without coma.

Key Diagnostic Point:

Hepatic failure, unspecified without coma, refers to a severe decline in liver function that can result from various underlying conditions, including chronic liver disease, acute liver injury, or toxic exposure. Clinically, patients may present with symptoms such as jaundice, fatigue, ascites, and coagulopathy, although they do not exhibit signs of hepatic encephalopathy or coma. 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; acute hepatic failure may develop rapidly, while chronic hepatic failure can evolve over months to years. Diagnostic considerations include laboratory tests assessing liver function (e.g., liver enzymes, bilirubin levels), imaging studies (e.g., ultrasound, CT scan), and sometimes liver biopsy to determine the underlying cause. Accurate diagnosis is essential for appropriate management and treatment, which may involve addressing the underlying cause, nutritional support, and in severe cases, liver transplantation.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation of liver function and potential etiologies.
  • Treatment complexity: Management may involve multidisciplinary approaches depending on the underlying cause.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: While K72.90 is specific, it lacks detail on the underlying cause, which may complicate coding.

Audit Risk Factors

  • Common coding errors: Misclassification of hepatic failure types or failure to specify underlying conditions.
  • Documentation gaps: Insufficient clinical details to justify the diagnosis or treatment.
  • Billing challenges: Potential for denials if documentation does not clearly support the diagnosis.

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

Hepatic failure significantly impacts population health, as it can lead to increased morbidity and mortality rates. Understanding the epidemiology of liver diseases is crucial for healthcare providers to implement preventive measures and improve patient outcomes. Quality measures related to liver health, such as screening for hepatitis and alcohol use, can help reduce the incidence of hepatic failure. Additionally, healthcare utilization patterns show that patients with hepatic failure often require extensive medical resources, including hospitalization and specialist care.

ICD-9 vs ICD-10

Hepatic failure significantly impacts population health, as it can lead to increased morbidity and mortality rates. Understanding the epidemiology of liver diseases is crucial for healthcare providers to implement preventive measures and improve patient outcomes. Quality measures related to liver health, such as screening for hepatitis and alcohol use, can help reduce the incidence of hepatic failure. Additionally, healthcare utilization patterns show that patients with hepatic failure often require extensive medical resources, including hospitalization and specialist care.

Reimbursement & Billing Impact

Reimbursement considerations include the need for comprehensive clinical notes that detail the patient's condition, laboratory results, and treatment plans. Common denials may arise from insufficient documentation or failure to link the diagnosis to the services provided. Coders should ensure that all relevant information is captured to support the medical necessity of the services rendered, including any consultations or diagnostic tests performed.

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 K72.90?

K72.90 encompasses various forms of hepatic failure that do not specify the underlying cause, including but not limited to acute liver failure, chronic liver disease exacerbations, and liver dysfunction due to toxins or medications.

When should K72.90 be used instead of related codes?

K72.90 should be used when hepatic failure is diagnosed but the specific cause is not determined or documented. If a specific etiology is known, such as alcoholic liver disease or viral hepatitis, more specific codes should be utilized.

What documentation supports K72.90?

Documentation should include clinical findings, laboratory results indicating liver dysfunction, imaging studies, and any relevant history of liver disease or potential toxins. Clear notes on the absence of coma are also essential.