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ICD-10 Guide
ICD-10 CodesK76.5

K76.5

Billable

Hepatic veno-occlusive disease

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

Code Description

ICD-10 K76.5 is a billable code used to indicate a diagnosis of hepatic veno-occlusive disease.

Key Diagnostic Point:

Hepatic veno-occlusive disease (HVOD) is a condition characterized by the obstruction of hepatic venules, leading to hepatic congestion and subsequent liver damage. Clinically, patients may present with symptoms such as jaundice, hepatomegaly, ascites, and abdominal pain. The anatomy involved primarily includes the hepatic veins and the portal venous system, which are crucial for normal liver function and blood flow. Disease progression can vary; in acute cases, symptoms may develop rapidly following exposure to certain toxins, chemotherapy, or following liver transplantation. Chronic cases may lead to cirrhosis and liver failure if not managed appropriately. Diagnostic considerations include imaging studies such as ultrasound, CT, or MRI to assess liver morphology and blood flow, along with liver biopsy to confirm the diagnosis histologically. Laboratory tests may reveal elevated liver enzymes, bilirubin levels, and coagulopathy, which are indicative of liver dysfunction.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity: Requires a combination of imaging and histological confirmation.
  • Treatment complexity: Management may involve addressing underlying causes, supportive care, and in severe cases, liver transplantation.
  • Documentation requirements: Comprehensive documentation of clinical findings, imaging results, and treatment plans is essential.
  • Coding specificity: Requires precise coding to differentiate from other liver conditions such as cirrhosis or portal hypertension.

Audit Risk Factors

  • Common coding errors: Misclassification with other liver diseases.
  • Documentation gaps: Incomplete clinical notes or lack of imaging results.
  • Billing challenges: Potential denials due to insufficient evidence of medical necessity.

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 veno-occlusive disease has significant clinical implications, particularly in populations undergoing chemotherapy or liver transplantation. The condition can lead to severe liver dysfunction, impacting patient quality of life and increasing healthcare utilization due to hospitalizations and potential need for liver transplantation. Understanding HVOD is crucial for improving patient outcomes and implementing effective quality measures in liver disease management.

ICD-9 vs ICD-10

Hepatic veno-occlusive disease has significant clinical implications, particularly in populations undergoing chemotherapy or liver transplantation. The condition can lead to severe liver dysfunction, impacting patient quality of life and increasing healthcare utilization due to hospitalizations and potential need for liver transplantation. Understanding HVOD is crucial for improving patient outcomes and implementing effective quality measures in liver disease management.

Reimbursement & Billing Impact

Reimbursement considerations include the necessity for imaging studies and laboratory tests that confirm the diagnosis. Common denials may arise from insufficient documentation or failure to demonstrate medical necessity for procedures related to HVOD. Best practices include ensuring all clinical notes are complete, accurate, and reflect the patient's condition and treatment plan.

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 K76.5?

K76.5 specifically covers hepatic veno-occlusive disease, which may arise from various etiologies including chemotherapy, toxins, and certain infections. It is important to differentiate HVOD from other liver conditions such as cirrhosis or portal vein thrombosis.

When should K76.5 be used instead of related codes?

K76.5 should be used when there is clear evidence of hepatic venous obstruction leading to liver dysfunction, particularly when associated with specific risk factors or clinical presentations that distinguish it from other liver diseases.

What documentation supports K76.5?

Documentation should include clinical findings such as symptoms, imaging studies showing venous obstruction, laboratory results indicating liver dysfunction, and any relevant history of exposure to risk factors like chemotherapy or toxins.