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ICD-10 Guide
ICD-10 CodesK74.02

K74.02

Billable

Hepatic fibrosis, advanced fibrosis

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

Code Description

ICD-10 K74.02 is a billable code used to indicate a diagnosis of hepatic fibrosis, advanced fibrosis.

Key Diagnostic Point:

Hepatic fibrosis, advanced fibrosis, is a progressive condition characterized by excessive accumulation of extracellular matrix proteins, leading to scarring of the liver tissue. Clinically, patients may present with symptoms such as fatigue, jaundice, ascites, and abdominal discomfort, although advanced fibrosis can often be asymptomatic until significant liver damage occurs. The liver, a vital organ in the digestive system, plays a crucial role in metabolism, detoxification, and synthesis of proteins. As fibrosis progresses, it can lead to cirrhosis, portal hypertension, and liver failure. Diagnostic considerations include imaging studies such as ultrasound, CT, or MRI, and liver biopsy, which can confirm the degree of fibrosis. Non-invasive methods like elastography are also increasingly used to assess liver stiffness as an indicator of fibrosis severity. Regular monitoring and early intervention are essential to manage underlying causes, such as chronic hepatitis or alcohol use, to prevent further liver damage.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors
  • Documentation gaps
  • Billing challenges

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

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Hepatic fibrosis, particularly in its advanced stages, poses significant clinical challenges and impacts population health due to its association with liver cirrhosis and increased risk of hepatocellular carcinoma. Effective management of advanced fibrosis can improve patient outcomes and reduce healthcare utilization, as it often requires ongoing monitoring and potential interventions. Understanding the epidemiology of liver diseases leading to fibrosis is crucial for public health initiatives aimed at prevention and early detection.

ICD-9 vs ICD-10

Hepatic fibrosis, particularly in its advanced stages, poses significant clinical challenges and impacts population health due to its association with liver cirrhosis and increased risk of hepatocellular carcinoma. Effective management of advanced fibrosis can improve patient outcomes and reduce healthcare utilization, as it often requires ongoing monitoring and potential interventions. Understanding the epidemiology of liver diseases leading to fibrosis is crucial for public health initiatives aimed at prevention and early detection.

Reimbursement & Billing Impact

Reimbursement considerations include the need for thorough clinical documentation to justify the diagnosis and any procedures performed. Common denials may arise from insufficient documentation or lack of evidence supporting the advanced fibrosis diagnosis. Best practices include ensuring all clinical notes, imaging results, and lab tests are clearly documented and linked to the diagnosis to facilitate smooth billing processes.

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 K74.02?

K74.02 specifically covers advanced hepatic fibrosis, which may arise from chronic liver diseases such as hepatitis B and C, alcoholic liver disease, and non-alcoholic fatty liver disease (NAFLD). It is essential to differentiate it from other stages of fibrosis and cirrhosis.

When should K74.02 be used instead of related codes?

K74.02 should be used when the patient has been diagnosed with advanced fibrosis, typically indicated by a significant increase in liver stiffness or confirmed by biopsy. It is crucial to use this code when there is clear evidence of advanced scarring, as opposed to mild or moderate fibrosis.

What documentation supports K74.02?

Documentation supporting K74.02 should include clinical notes detailing the patient's history of liver disease, results from imaging studies or liver biopsy confirming advanced fibrosis, and any relevant laboratory results indicating liver function impairment.