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K70.31
ICD-10-CM
Alcoholic Cirrhosis of Liver with Ascites

Alcoholic cirrhosis of liver with ascites diagnosis information for healthcare professionals. Find clinical documentation and medical coding details for alcoholic liver cirrhosis with ascites, including alcohol-induced cirrhosis with ascites. Learn about diagnosis, treatment, and management of this condition.

Also known as

Alcoholic Liver Cirrhosis with Ascites
Alcohol-Induced Cirrhosis with Ascites

Diagnosis Snapshot

Key Facts
  • Definition : Scarring of the liver due to long-term heavy alcohol use, causing fluid buildup in the abdomen.
  • Clinical Signs : Swollen abdomen, jaundice, fatigue, nausea, weight loss, confusion, and easy bruising.
  • Common Settings : Hospital inpatient, outpatient clinic, and primary care settings.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC K70.31 Coding
K70.3

Alcoholic cirrhosis of liver with ascites

Liver disease caused by long-term alcohol use with fluid buildup in the abdomen.

K70

Alcoholic liver disease

Liver damage due to excessive alcohol consumption.

R18

Ascites

Abnormal fluid accumulation in the abdominal cavity.

F10

Mental and behavioural disorders due to use of alcohol

Conditions related to alcohol use impacting mental and behavioral health.

Code-Specific Guidance

Decision Tree for

Follow this step-by-step guide to choose the correct ICD-10 code.

Is the cirrhosis definitively due to alcohol?

  • Yes

    Is ascites present?

  • No

    Is another cause of cirrhosis documented?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Liver scarring with fluid buildup due to alcohol.
Liver scarring due to alcohol, no fluid buildup.
Fluid buildup in abdomen, cause unspecified.

Documentation Best Practices

Documentation Checklist
  • Document history of chronic alcohol abuse.
  • Evidence of ascites (e.g., physical exam, imaging).
  • Liver function tests and imaging results.
  • Rule out other causes of cirrhosis.
  • ICD-10-CM code: K70.31

Coding and Audit Risks

Common Risks
  • Unspecified Etiology

    Coding ascites without confirming alcoholic etiology may lead to inaccurate DRG assignment and lost revenue.

  • Comorbidity Capture

    Failing to code associated conditions like hepatic encephalopathy or esophageal varices impacts risk adjustment and reimbursement.

  • Clinical Validation

    Insufficient documentation linking ascites directly to alcoholic cirrhosis can cause claim denials for lacking medical necessity.

Mitigation Tips

Best Practices
  • Stop alcohol use. Code K70.3, I85.0. Document cessation support.
  • Manage ascites: diuretics, paracentesis. I85.0, R18. Document fluid balance.
  • Nutritional support: high protein, vitamins. K70.3, E43, E56. Document needs.
  • Screen for hepatic encephalopathy. K72. Code severity, document mental status.
  • Monitor/treat complications: varices, infections. I85, K76.4. Specific coding.

Clinical Decision Support

Checklist
  • Verify history of chronic alcohol abuse.
  • Document ascites presence (e.g., ultrasound, exam).
  • Check for liver function abnormalities (LFTs).
  • Rule out other cirrhosis causes (viral, autoimmune).
  • Assess for hepatic encephalopathy and varices.

Reimbursement and Quality Metrics

Impact Summary
  • Alcoholic Cirrhosis with Ascites reimbursement hinges on accurate ICD-10-CM K70.41 coding and supporting documentation.
  • Quality metrics for K70.41 (Alcoholic Cirrhosis with Ascites) impact hospital readmission rates and resource utilization.
  • Proper coding of complications like hepatic encephalopathy and variceal bleeding maximizes case-mix index (CMI) for K70.41.
  • Timely diagnosis and intervention for K70.41 affect hospital value-based purchasing and performance metrics.

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Frequently Asked Questions

Common Questions and Answers

Q: What are the key differentiating diagnostic markers between alcoholic cirrhosis with ascites and other causes of ascites and cirrhosis?

A: Diagnosing alcoholic cirrhosis with ascites requires careful differentiation from other etiologies of cirrhosis and ascites, such as non-alcoholic fatty liver disease (NAFLD), viral hepatitis, and heart failure. Key markers suggestive of alcoholic etiology include a history of chronic alcohol abuse, elevated AST:ALT ratio (typically >2:1), macrocytic anemia, and potentially elevated GGT and MCV. Imaging studies, including ultrasound, CT, or MRI, can reveal specific findings like nodular liver surface and splenomegaly. However, liver biopsy remains the gold standard for definitive diagnosis and staging of fibrosis, although it is not always necessary. Consider implementing a comprehensive diagnostic approach encompassing detailed patient history, laboratory tests (including liver function tests, coagulation profile, and complete blood count), and imaging to accurately differentiate alcoholic cirrhosis with ascites. Explore how advanced diagnostic tools, like transient elastography, can aid in assessing liver stiffness non-invasively.

Q: How do I manage a patient with alcoholic cirrhosis and ascites who presents with hepatic encephalopathy?

A: Managing hepatic encephalopathy in a patient with alcoholic cirrhosis and ascites requires a multi-faceted approach. First, identify and address precipitating factors such as infections (e.g., spontaneous bacterial peritonitis), gastrointestinal bleeding, or electrolyte imbalances. Lactulose is a cornerstone of therapy, aiming to reduce ammonia levels. Rifaximin can be added to lactulose for patients unresponsive to lactulose alone or for secondary prophylaxis of hepatic encephalopathy. Close monitoring of neurological status, including mental status examination and EEG if needed, is crucial. Supportive care measures, such as fluid and electrolyte management, are essential. Explore how specialized nutritional support, including branched-chain amino acids, can play a role in managing hepatic encephalopathy. Learn more about the latest guidelines for preventing and treating hepatic encephalopathy in patients with alcoholic cirrhosis and ascites.

Quick Tips

Practical Coding Tips
  • Code K70.4 for ascites
  • Code K70.3 for cirrhosis
  • Document alcohol etiology
  • Query physician if unclear
  • Consider secondary diagnoses

Documentation Templates

Patient presents with complaints consistent with alcoholic cirrhosis of liver with ascites.  Symptoms include abdominal distension, shortness of breath, and fatigue.  Physical examination reveals hepatomegaly, splenomegaly, and shifting dullness indicative of ascites.  The patient reports a history of chronic alcohol abuse.  Laboratory findings demonstrate elevated liver enzymes (AST, ALT, GGT), low albumin, prolonged prothrombin time, and thrombocytopenia.  Ultrasound imaging confirms the presence of cirrhosis and ascites.  Diagnosis of alcoholic liver cirrhosis with ascites is established based on clinical presentation, laboratory data, and imaging studies.  Differential diagnoses considered included non-alcoholic fatty liver disease, viral hepatitis, and heart failure.  Treatment plan includes alcohol abstinence, sodium restriction, diuretics (spironolactone and furosemide), and paracentesis for symptomatic relief of ascites.  Patient education provided on the importance of lifestyle modifications, medication adherence, and regular follow-up appointments to monitor disease progression and potential complications such as hepatic encephalopathy, variceal bleeding, and hepatorenal syndrome.  ICD-10 code K70.31 is assigned for alcoholic cirrhosis of liver with ascites.  Referral to hepatology and nutrition services are recommended.