ICD-10 Coding for Biliary Cirrhosis(K74.3, K74.4, K74.5, K83.0)
Complete ICD-10-CM coding and documentation guide for Biliary Cirrhosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Biliary Cirrhosis
K74.3-K74.5Primary Range
Biliary cirrhosis codes
These codes cover primary, secondary, and unspecified biliary cirrhosis.
Primary biliary cholangitis
This code is used for primary biliary cholangitis, reflecting updated terminology.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K74.3 | Primary biliary cirrhosis | Use when documentation specifies primary biliary cirrhosis with supporting lab results. |
|
| K74.4 | Secondary biliary cirrhosis | Use when cirrhosis is due to a secondary cause like bile duct obstruction. |
|
| K74.5 | Unspecified biliary cirrhosis | Use when documentation does not specify primary or secondary. | |
| K83.0 | Primary biliary cholangitis | Use when documentation specifies primary biliary cholangitis without cirrhosis. |
|
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 primary biliary cirrhosis
Essential facts and insights about Biliary Cirrhosis
Primary ICD-10-CM Codes for biliary cirrhosis
Decision Criteria
clinical Criteria
- Presence of AMA positivity and elevated ALP
documentation Criteria
- Explicit mention of 'primary biliary cirrhosis'
Applicable To
- Primary biliary cholangitis
Excludes
- Secondary biliary cirrhosis (K74.4)
Clinical Validation Requirements
- AMA positivity
- Elevated ALP
- Liver biopsy findings
Code-Specific Risks
- Confusion with secondary biliary cirrhosis
- Misclassification as unspecified biliary cirrhosis
Coding Notes
- Ensure documentation specifies 'primary' and includes lab results.
K74.4 - Secondary biliary cirrhosis
Use when cirrhosis is due to a secondary cause like bile duct obstruction.
Applicable To
- Cirrhosis due to bile duct obstruction
Excludes
- Primary biliary cirrhosis (K74.3)
Clinical Validation Requirements
- Imaging showing bile duct obstruction
- ERCP findings
Coding Notes
Ensure documentation links cirrhosis to a secondary cause.
K74.5 - Unspecified biliary cirrhosis
Use when documentation does not specify primary or secondary.
Excludes
- Primary biliary cirrhosis (K74.3)
- Secondary biliary cirrhosis (K74.4)
Coding Notes
Query provider for more specific information if possible.
K83.0 - Primary biliary cholangitis
Use when documentation specifies primary biliary cholangitis without cirrhosis.
Excludes
- Primary biliary cirrhosis (K74.3)
Clinical Validation Requirements
- AMA positivity
- Elevated ALP
Coding Notes
Verify if the term 'cholangitis' is used synonymously with cirrhosis.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Biliary Cirrhosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K74.3.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials or reduced reimbursement.
Mitigation Strategy
Ensure detailed documentation of etiology., Include all relevant lab and imaging results.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure documentation specifies the cause of cirrhosis.
Impact
Reimbursement: Potential reduction in reimbursement., Compliance: Fails to meet specificity requirements., Data Quality: Decreased data accuracy for clinical research.
Mitigation Strategy
Query provider for more specific information.
Impact
Using unspecified codes when specific codes are applicable.
Mitigation Strategy
Ensure documentation supports the most specific code.
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 Biliary Cirrhosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Biliary Cirrhosis
Use these documentation templates to ensure complete and accurate documentation for Biliary Cirrhosis. These templates include all required elements for proper coding and billing.
Diagnosis of primary biliary cirrhosis
Specialty: GastroenterologyRequired Elements
- AMA titer
- ALP levels
- Liver biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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