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ICD-10 Guide
ICD-10 CodesK74.6

K74.6

Non-billable

Other and unspecified cirrhosis of liver

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

Code Description

ICD-10 K74.6 is a used to indicate a diagnosis of other and unspecified cirrhosis of liver.

Key Diagnostic Point:

K74.6 refers to 'Other and unspecified cirrhosis of liver,' a condition characterized by the progressive replacement of healthy liver tissue with scar tissue (fibrosis), leading to impaired liver function. The liver, a vital organ in the digestive system, plays a crucial role in metabolism, detoxification, and the production of essential proteins. Cirrhosis can result from various etiologies, including chronic viral hepatitis, alcohol abuse, and metabolic disorders. Clinically, patients may present with symptoms such as fatigue, jaundice, ascites, and portal hypertension. Disease progression can lead to complications like liver failure and hepatocellular carcinoma. Diagnosis typically involves a combination of clinical evaluation, laboratory tests (e.g., liver function tests, viral serologies), imaging studies (ultrasound, CT, MRI), and sometimes liver biopsy. The absence of a specific underlying cause or the inability to classify the cirrhosis further necessitates the use of K74.6, making it essential for coders to accurately capture the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires comprehensive evaluation to determine etiology and stage of cirrhosis.
  • Treatment complexity: Management may involve lifestyle modifications, medications, and potential liver transplantation.
  • Documentation requirements: Detailed clinical documentation is necessary to support the diagnosis and treatment plan.
  • Coding specificity: While K74.6 is specific, it lacks the granularity of codes that identify the underlying cause of cirrhosis.

Audit Risk Factors

  • Common coding errors: Misclassification of cirrhosis type or failure to document the underlying cause.
  • Documentation gaps: Incomplete patient history or lack of supporting lab/imaging results.
  • 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

Cirrhosis of the liver significantly impacts population health, contributing to morbidity and mortality rates associated with liver disease. It is a leading cause of liver-related complications, necessitating increased healthcare utilization, including hospital admissions and liver transplants. Quality measures often focus on early detection and management of cirrhosis to prevent progression to liver failure. Epidemiologically, the prevalence of cirrhosis is rising, particularly in populations with high rates of alcohol use and viral hepatitis, highlighting the need for effective public health interventions.

ICD-9 vs ICD-10

Cirrhosis of the liver significantly impacts population health, contributing to morbidity and mortality rates associated with liver disease. It is a leading cause of liver-related complications, necessitating increased healthcare utilization, including hospital admissions and liver transplants. Quality measures often focus on early detection and management of cirrhosis to prevent progression to liver failure. Epidemiologically, the prevalence of cirrhosis is rising, particularly in populations with high rates of alcohol use and viral hepatitis, highlighting the need for effective public health interventions.

Reimbursement & Billing Impact

Reimbursement may be affected by the specificity of the documentation; therefore, coders should be vigilant about including all pertinent details. Common denials may arise from insufficient documentation or misclassification of the cirrhosis type. It is essential to follow coding best practices and ensure that the medical necessity for any procedures or treatments is clearly articulated in the patient’s 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 K74.6?

K74.6 encompasses cirrhosis not classified elsewhere, including cases where the underlying cause is unknown or not specified. This may include idiopathic cirrhosis or cirrhosis resulting from multiple factors.

When should K74.6 be used instead of related codes?

K74.6 should be used when cirrhosis is present without a clear etiology or when the specific type of cirrhosis cannot be determined. Coders should ensure that all other specific codes have been considered and ruled out.

What documentation supports K74.6?

Documentation must include a comprehensive assessment of the patient's liver function, any relevant imaging studies, laboratory results, and a clear statement from the physician regarding the diagnosis of cirrhosis and its unspecified nature.