ICD-10 Coding for Abnormal Liver Function Tests(R94.5, K70.10)
Complete ICD-10-CM coding and documentation guide for Abnormal Liver Function Tests. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Liver Function Tests
R94.5Primary Range
Abnormal results of liver function studies
Used when liver function tests are abnormal without a definitive diagnosis.
Diseases of the liver
Used when a specific liver disease is diagnosed, such as alcoholic liver disease or cirrhosis.
Abnormal serum enzyme levels
Used for specific enzyme elevations like transaminases when not part of a broader study.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R94.5 | Abnormal results of liver function studies | Use when liver function tests are abnormal but no specific liver disease is diagnosed. |
|
| K70.10 | Alcoholic hepatitis without ascites | Use when alcoholic hepatitis is diagnosed. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for abnormal liver function tests
Essential facts and insights about Abnormal Liver Function Tests
Primary ICD-10-CM Codes for abnormal liver function tests
Decision Criteria
clinical Criteria
- Abnormal liver function tests without a specific diagnosis.
coding Criteria
- No specific liver disease code applicable.
Applicable To
- Abnormal liver function tests
Excludes
- Specific liver diseases (K70-K77)
Clinical Validation Requirements
- Documented abnormal liver function tests without a specific diagnosis.
Code-Specific Risks
- Risk of under-coding if a specific liver disease is present.
Coding Notes
- Ensure documentation supports the use of R94.5 by excluding specific liver diseases.
K70.10 - Alcoholic hepatitis without ascites
Use when alcoholic hepatitis is diagnosed.
Applicable To
- Alcoholic liver disease with hepatitis
Excludes
- Alcoholic cirrhosis (K70.30)
Clinical Validation Requirements
- Documented diagnosis of alcoholic hepatitis.
Coding Notes
Document alcohol use and hepatitis diagnosis clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Upper abdominal pain
R10.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abnormal Liver Function Tests to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R94.5.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the exclusion of specific liver diseases.
Impact
Reimbursement: May lead to claim denials or reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use the specific liver disease code (e.g., K70.10 for alcoholic hepatitis).
Impact
High risk of audit if R94.5 is used without excluding specific liver diseases.
Mitigation Strategy
Ensure thorough documentation of diagnostic exclusions.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abnormal Liver Function Tests, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Liver Function Tests
Use these documentation templates to ensure complete and accurate documentation for Abnormal Liver Function Tests. These templates include all required elements for proper coding and billing.
Abnormal LFTs without specific diagnosis
Specialty: GastroenterologyRequired Elements
- Patient history
- Liver function test results
- Imaging studies
- Exclusion of specific liver diseases
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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