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ICD-10 Guide
ICD-10 CodesK74.2

K74.2

Billable

Hepatic fibrosis with hepatic sclerosis

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

Code Description

ICD-10 K74.2 is a billable code used to indicate a diagnosis of hepatic fibrosis with hepatic sclerosis.

Key Diagnostic Point:

Hepatic fibrosis with hepatic sclerosis is characterized by the excessive accumulation of extracellular matrix proteins, leading to scarring of the liver tissue. This condition often arises as a consequence of chronic liver diseases such as hepatitis, alcohol abuse, or non-alcoholic fatty liver disease. Clinically, patients may present with symptoms such as fatigue, jaundice, ascites, and abdominal discomfort, although many may remain asymptomatic in the early stages. The liver anatomy involved includes hepatocytes, portal tracts, and the hepatic vasculature, which become progressively altered as fibrosis advances. Disease progression can lead to cirrhosis, portal hypertension, and ultimately liver failure if not managed appropriately. Diagnostic considerations include liver function tests, imaging studies like ultrasound or MRI, and liver biopsy, which can confirm the degree of fibrosis and rule out other conditions. Regular monitoring and early intervention are crucial to prevent complications associated with advanced liver disease.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

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

Audit Risk Factors

  • Common coding errors include misclassification of the severity of fibrosis.
  • Documentation gaps may arise from insufficient detail in liver biopsy reports.
  • Billing challenges can occur if the condition is not clearly linked to the underlying cause.

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 fibrosis with hepatic sclerosis has significant clinical implications, as it can lead to serious complications such as cirrhosis and liver failure, impacting population health. Early identification and management can improve patient outcomes and reduce healthcare utilization. Quality measures focus on regular monitoring of liver function and timely intervention, which are crucial for preventing disease progression and associated morbidity.

ICD-9 vs ICD-10

Hepatic fibrosis with hepatic sclerosis has significant clinical implications, as it can lead to serious complications such as cirrhosis and liver failure, impacting population health. Early identification and management can improve patient outcomes and reduce healthcare utilization. Quality measures focus on regular monitoring of liver function and timely intervention, which are crucial for preventing disease progression and associated morbidity.

Reimbursement & Billing Impact

Reimbursement considerations include ensuring that the underlying cause of liver disease is clearly documented, as this can affect payment rates. Common denials may arise from lack of specificity in the diagnosis or insufficient documentation linking the condition to the patient's symptoms. Best practices include maintaining thorough clinical notes and ensuring that all diagnostic tests are clearly outlined in the patient's medical record.

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 K74.2?

K74.2 specifically covers hepatic fibrosis accompanied by hepatic sclerosis, often resulting from chronic liver diseases such as viral hepatitis, alcoholic liver disease, or autoimmune hepatitis. It is essential to differentiate this from other forms of liver fibrosis that do not involve sclerosis.

When should K74.2 be used instead of related codes?

K74.2 should be used when there is clear evidence of hepatic fibrosis with accompanying sclerosis, as indicated by imaging or biopsy results. If fibrosis is present without sclerosis, K74.0 should be selected instead.

What documentation supports K74.2?

Documentation should include liver function tests, imaging studies, and a definitive liver biopsy report indicating the presence of fibrosis and sclerosis. Clinical notes should detail the patient's history of liver disease and any relevant symptoms.