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ICD-10 Guide
ICD-10 CodesK74.00

K74.00

Billable

Hepatic fibrosis, unspecified

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

Code Description

ICD-10 K74.00 is a billable code used to indicate a diagnosis of hepatic fibrosis, unspecified.

Key Diagnostic Point:

Hepatic fibrosis, unspecified, refers to the excessive accumulation of extracellular matrix proteins, leading to scarring of the liver tissue. This condition often arises from chronic liver diseases such as hepatitis, alcoholic liver disease, or non-alcoholic fatty liver disease. Clinically, patients may present with nonspecific symptoms, including fatigue, weakness, and abdominal discomfort, but many remain asymptomatic until advanced stages. The liver anatomy involved includes hepatocytes, portal tracts, and sinusoids, which are crucial for liver function and metabolism. Disease progression can lead to cirrhosis, liver failure, or hepatocellular carcinoma if the underlying cause is not addressed. Diagnostic considerations include liver function tests, imaging studies (such as ultrasound or MRI), and liver biopsy, which may be necessary to assess the degree of fibrosis. The absence of specific symptoms and the variability in disease progression complicate the diagnosis and management of hepatic fibrosis.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation and may involve multiple specialties.
  • Treatment complexity: Management often involves addressing underlying causes and may require multidisciplinary approaches.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: While K74.00 is specific, it may require differentiation from other liver-related codes.

Audit Risk Factors

  • Common coding errors: Misclassification of the severity of fibrosis or related liver conditions.
  • Documentation gaps: Lack of comprehensive clinical notes to support the diagnosis.
  • Billing challenges: Potential for denials if documentation does not clearly establish the diagnosis or treatment.

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Hepatic fibrosis has significant clinical implications, as it can progress to more severe liver diseases, impacting population health. Early diagnosis and management can improve patient outcomes and reduce healthcare utilization. Quality measures related to liver health often focus on screening and managing chronic liver diseases, emphasizing the importance of accurate coding and documentation in improving care delivery and epidemiological tracking.

ICD-9 vs ICD-10

Hepatic fibrosis has significant clinical implications, as it can progress to more severe liver diseases, impacting population health. Early diagnosis and management can improve patient outcomes and reduce healthcare utilization. Quality measures related to liver health often focus on screening and managing chronic liver diseases, emphasizing the importance of accurate coding and documentation in improving care delivery and epidemiological tracking.

Reimbursement & Billing Impact

Reimbursement considerations include the need for clear evidence of medical necessity for liver-related services. Common denials may arise from insufficient documentation or failure to demonstrate the relationship between the diagnosis and the provided services. Best practices include maintaining thorough records of all clinical interactions and ensuring that coding aligns with the documented findings.

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 K74.00?

K74.00 covers unspecified hepatic fibrosis, which may result from various chronic liver diseases, including viral hepatitis, alcoholic liver disease, and metabolic disorders. It does not specify the cause or severity of fibrosis.

When should K74.00 be used instead of related codes?

K74.00 should be used when the specific cause of hepatic fibrosis is unknown or not documented. If the cause is known, more specific codes such as K74.01 or K74.02 should be utilized.

What documentation supports K74.00?

Documentation should include clinical findings, laboratory results indicating liver function, imaging studies, and any relevant history of liver disease. A clear treatment plan and follow-up notes are also essential.