ICD-10 Coding for Portal Hypertension(K76.6, K74.60)
Complete ICD-10-CM coding and documentation guide for Portal Hypertension. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Portal Hypertension
K76.6Primary Range
Portal hypertension
Primary code for portal hypertension, used when the condition is not linked to another underlying cause.
Cirrhosis of liver
Used when portal hypertension is due to cirrhosis, requiring linkage in documentation.
Esophageal varices
Used for complications such as esophageal varices due to portal hypertension.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K76.6 | Portal hypertension | Use when portal hypertension is diagnosed without a specified cause. |
|
| K74.60 | Cirrhosis of liver without ascites | Use when cirrhosis is the underlying cause of portal hypertension. |
|
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 portal hypertension
Essential facts and insights about Portal Hypertension
Primary ICD-10-CM Codes for portal hypertension
Decision Criteria
clinical Criteria
- Diagnosis of portal hypertension without specified etiology.
Applicable To
- Portal hypertension of unknown etiology
Excludes
- Portal vein thrombosis (I81)
Clinical Validation Requirements
- Imaging showing portal vein diameter >13 mm
- HVPG ≥10 mmHg
Code-Specific Risks
- Incorrectly used without specifying etiology when known.
Coding Notes
- Ensure documentation specifies if portal hypertension is due to another condition.
K74.60 - Cirrhosis of liver without ascites
Use when cirrhosis is the underlying cause of portal hypertension.
Applicable To
- Cirrhosis due to hepatitis C
Excludes
- Alcoholic cirrhosis (K70.30)
Clinical Validation Requirements
- Liver biopsy confirming cirrhosis
- Imaging showing nodular liver
Coding Notes
Document the cause of cirrhosis to ensure correct coding.
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 Portal Hypertension to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K76.6.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Educate providers on the importance of linking conditions.
Impact
Reimbursement: Incorrect DRG assignment leading to potential underpayment., Compliance: Non-compliance with coding guidelines requiring specificity., Data Quality: Inaccurate data affecting clinical outcomes and research.
Mitigation Strategy
Query the provider to confirm if portal hypertension is due to cirrhosis or another condition.
Impact
Failure to document the linkage between portal hypertension and its cause.
Mitigation Strategy
Implement provider education and regular audits.
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 Portal Hypertension, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Portal Hypertension
Use these documentation templates to ensure complete and accurate documentation for Portal Hypertension. These templates include all required elements for proper coding and billing.
Cirrhosis with portal hypertension and varices
Specialty: GastroenterologyRequired Elements
- Cirrhosis etiology
- Portal hypertension linkage
- Complications such as varices
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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