ICD-10 Coding for Primary Biliary Cirrhosis(K74.3, K83.0)
Complete ICD-10-CM coding and documentation guide for Primary Biliary Cirrhosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Primary Biliary Cirrhosis
K74-K75Primary Range
Fibrosis and cirrhosis of liver
This range includes codes for liver fibrosis and cirrhosis, which are relevant for coding primary biliary cirrhosis when cirrhosis is present.
Other diseases of biliary tract
This range includes codes for biliary tract diseases, such as cholangitis, which is relevant when cirrhosis is not present.
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 explicitly states 'primary biliary cirrhosis' and cirrhosis is confirmed. |
|
| K83.0 | Cholangitis, primary | Use when documentation states '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 Primary Biliary Cirrhosis
Primary ICD-10-CM Codes for primary biliary cirrhosis
Decision Criteria
clinical Criteria
- Liver biopsy confirms cirrhosis.
documentation Criteria
- Explicit mention of 'primary biliary cirrhosis'.
Applicable To
- Primary biliary cholangitis with cirrhosis
Excludes
- Secondary biliary cirrhosis (K74.60)
Clinical Validation Requirements
- Liver biopsy confirming cirrhosis
- Imaging showing nodular liver surface
- Lab evidence of cirrhosis (e.g., platelet <150k, albumin <3.5 g/dL)
Code-Specific Risks
- Misuse when cirrhosis isn't documented
Coding Notes
- Ensure cirrhosis is documented before using K74.3.
K83.0 - Cholangitis, primary
Use when documentation states 'primary biliary cholangitis' without cirrhosis.
Applicable To
- Primary biliary cholangitis without cirrhosis
Excludes
- Primary biliary cirrhosis (K74.3)
Clinical Validation Requirements
- AMA positivity
- Elevated alkaline phosphatase >1.5x ULN for >6 months
Coding Notes
Ensure cirrhosis is not documented before using K83.0.
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 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: May lead to incorrect treatment plans., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.
Mitigation Strategy
Use specific terms like 'primary biliary cirrhosis'., Include lab and imaging findings.
Impact
Reimbursement: Incorrect DRG assignment may affect payment., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Query provider to confirm presence/absence of cirrhosis.
Impact
Risk of using incorrect codes due to vague documentation.
Mitigation Strategy
Implement thorough documentation practices 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 Primary Biliary Cirrhosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Primary Biliary Cirrhosis
Use these documentation templates to ensure complete and accurate documentation for Primary Biliary Cirrhosis. These templates include all required elements for proper coding and billing.
Hepatology Progress Note
Specialty: HepatologyRequired Elements
- Diagnosis
- Stage
- Complications
- Labs
- Imaging
- Plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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