ICD-10 Coding for Primary Biliary Cholangitis(K83.0, K74.3)
Complete ICD-10-CM coding and documentation guide for Primary Biliary Cholangitis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Primary Biliary Cholangitis
K74-K83Primary Range
Diseases of liver and biliary tract
Includes codes for liver diseases, specifically cholangitis and cirrhosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| K83.0 | Cholangitis | Use when PBC is documented without cirrhosis. |
|
| K74.3 | Primary biliary cirrhosis with cirrhosis | Use when cirrhosis is documented with PBC. |
|
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 cholangitis
Essential facts and insights about Primary Biliary Cholangitis
Primary ICD-10-CM Codes for primary biliary cholangitis
Decision Criteria
documentation Criteria
- Absence of cirrhosis in clinical notes.
Applicable To
- Primary biliary cholangitis without cirrhosis
Excludes
- Primary biliary cirrhosis with cirrhosis (K74.3)
Clinical Validation Requirements
- AMA positivity
- Elevated ALP
- Liver biopsy showing florid duct lesions
Code-Specific Risks
- Misclassification if cirrhosis is present but not documented.
Coding Notes
- Ensure documentation specifies absence of cirrhosis.
K74.3 - Primary biliary cirrhosis with cirrhosis
Use when cirrhosis is documented with PBC.
Applicable To
- Primary biliary cholangitis with cirrhosis
Excludes
- Primary biliary cholangitis without cirrhosis (K83.0)
Clinical Validation Requirements
- Documentation of cirrhosis
- Liver biopsy showing cirrhosis
Coding Notes
Ensure cirrhosis is clearly documented.
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 Primary Biliary Cholangitis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K83.0.
Impact
Clinical: Misrepresentation of disease severity., Regulatory: Potential audit issues., Financial: Incorrect billing and reimbursement.
Mitigation Strategy
Ensure cirrhosis status is clearly documented., Use structured templates for liver disease documentation.
Impact
Reimbursement: Incorrect higher reimbursement risk., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Verify documentation for cirrhosis before coding.
Impact
Risk of coding errors if cirrhosis is not documented.
Mitigation Strategy
Implement mandatory documentation checks for cirrhosis.
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 Primary Biliary Cholangitis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Primary Biliary Cholangitis
Use these documentation templates to ensure complete and accurate documentation for Primary Biliary Cholangitis. These templates include all required elements for proper coding and billing.
PBC without cirrhosis
Specialty: HepatologyRequired Elements
- AMA titer
- ALP levels
- Liver biopsy results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Primary Biliary Cholangitis? Ask your questions below.