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

Understanding Cirrhosis of Liver with Ascites: This resource provides information on liver cirrhosis with ascites, including diagnosis, treatment, and management. Explore details on hepatic cirrhosis with ascites, clinical documentation tips for accurate medical coding, and healthcare resources for patients and professionals. Learn about the causes, symptoms, and prognosis of cirrhosis with ascites for improved patient care and accurate medical recordkeeping.

Also known as

Liver Cirrhosis with Ascites
Hepatic Cirrhosis with Ascites

Diagnosis Snapshot

Key Facts
  • Definition : Late-stage liver scarring causing fluid buildup in the abdomen.
  • Clinical Signs : Swollen abdomen, jaundice, fatigue, weight loss, edema, bruising.
  • Common Settings : Hospitalization, gastroenterology clinic, palliative care.

Related ICD-10 Code Ranges

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

Cirrhosis of liver without ascites

Chronic liver disease characterized by fibrosis and nodule formation.

K70.4

Alcoholic cirrhosis of liver

Cirrhosis resulting from excessive alcohol consumption.

K74.60

Ascites

Abnormal accumulation of fluid in the abdominal cavity.

I85

Esophageal varices

Dilated veins in the esophagus, often a complication of cirrhosis.

Code-Specific Guidance

Decision Tree for

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

Is the ascites due to the cirrhosis?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Liver scarring with fluid buildup
Liver scarring, no ascites
Fluid buildup in abdomen

Documentation Best Practices

Documentation Checklist
  • Document etiology of cirrhosis (alcohol, viral, etc.)
  • Ascites documented by physical exam or imaging
  • Severity of ascites (mild, moderate, tense)
  • Document complications (e.g., hepatic encephalopathy, varices)
  • Liver function tests and relevant labs documented

Coding and Audit Risks

Common Risks
  • Unspecified etiology

    Coding cirrhosis without specifying the cause (alcoholic, non-alcoholic, etc.) leads to inaccurate reporting and potential DRG misclassification.

  • Ascites documentation

    Insufficient documentation of ascites (e.g., clinical findings, imaging) may result in downcoding or claim denials for the associated complication.

  • Hepatic encephalopathy

    Co-occurring hepatic encephalopathy may be overlooked, leading to missed CC/MCC capture and inaccurate reflection of patient severity.

Mitigation Tips

Best Practices
  • Document etiology of cirrhosis (alcohol, NASH, etc.) for accurate ICD-10 coding (K74.x)
  • Clearly specify ascites severity (mild, moderate, tense) for appropriate HCC risk stratification
  • Detail all complications (e.g., hepatic encephalopathy, variceal bleeding) for complete clinical picture
  • Regularly assess and document MELD score for liver transplant evaluation and resource allocation
  • Code paracentesis procedures (e.g., 49080, 49081) with supporting documentation for compliance

Clinical Decision Support

Checklist
  • Verify documentation supports ascites AND cirrhosis etiology (ICD-10-CM K74.30, K70.30, K70.40, I85.0).
  • Confirm patient history, physical exam, and imaging findings correlate with ascites and cirrhosis.
  • Check for documentation of underlying liver disease contributing to cirrhosis.
  • Review labs (e.g., albumin, bilirubin, INR, creatinine) for liver dysfunction and ascites severity.
  • Assess for and document any complications of cirrhosis and ascites (e.g., hepatic encephalopathy, SBP).

Reimbursement and Quality Metrics

Impact Summary
  • Cirrhosis with ascites reimbursement: Optimize HCC coding, MELD score accuracy for appropriate MS-DRG assignment.
  • Coding accuracy impact: Correctly code ascites (R18) with cirrhosis (C21) for accurate APR-DRG grouping.
  • Quality metrics impact: Ascites documentation impacts quality measures related to hepatic encephalopathy, hepatorenal syndrome.
  • Hospital reporting impact: Accurate coding affects publicly reported outcomes for cirrhosis complications and mortality.

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Frequently Asked Questions

Common Questions and Answers

Q: What are the most effective diuretic strategies for managing refractory ascites in patients with cirrhosis of the liver?

A: Managing refractory ascites in cirrhosis requires a multifaceted approach. While spironolactone and furosemide are commonly used first-line diuretics, their efficacy can be limited in refractory cases. Current guidelines recommend escalating diuretic doses judiciously, but clinicians should carefully monitor for electrolyte imbalances and renal function. In cases truly refractory to high-dose diuretics, large-volume paracentesis becomes a necessary intervention, coupled with albumin infusion to maintain hemodynamic stability. Consider implementing a standardized paracentesis protocol to optimize patient outcomes. Explore how TIPS (transjugular intrahepatic portosystemic shunt) can be a valuable option for select patients who don't respond to medical management. Remember, careful patient selection and ongoing monitoring are critical for success with TIPS. Learn more about managing complications associated with advanced liver disease.

Q: How can I differentiate between spontaneous bacterial peritonitis (SBP) and other causes of ascites infection in a patient with liver cirrhosis with ascites?

A: Distinguishing spontaneous bacterial peritonitis (SBP) from secondary bacterial peritonitis in a patient with cirrhosis and ascites can be challenging. While both present with ascites infection, SBP arises without an intra-abdominal source, whereas secondary bacterial peritonitis typically stems from a perforated viscus, bowel ischemia, or other localized infection. Clinically, both can present with fever, abdominal pain, and altered mental status. However, key diagnostic features of SBP include an ascitic fluid polymorphonuclear leukocyte (PMN) count of 250 cells/mm3 or higher, often with a single organism on culture. Secondary bacterial peritonitis may have a higher PMN count, multiple organisms, and often requires imaging (CT abdomen) to identify the underlying source. Explore the latest guidelines on ascitic fluid analysis and consider implementing rapid diagnostic testing for SBP to facilitate timely treatment. Learn more about the role of antibiotic prophylaxis in preventing SBP recurrence.

Quick Tips

Practical Coding Tips
  • Code K74.60 for Liver Cirrhosis with Ascites
  • Document ascites cause and severity
  • Query physician for etiology documentation
  • Consider secondary diagnoses like esophageal varices
  • Review ICD-10-CM guidelines for K74.60

Documentation Templates

Patient presents with complaints consistent with decompensated cirrhosis of the liver, notably ascites.  Symptoms include abdominal distension, increased abdominal girth, and shortness of breath.  Physical examination reveals a distended abdomen with positive fluid wave, suggesting significant ascites.  Peripheral edema is also noted.  The patient's history includes chronic alcohol abuse, a significant risk factor for liver cirrhosis.  Laboratory findings demonstrate elevated liver enzymes (AST, ALT), hypoalbuminemia, prolonged prothrombin time (PT), and thrombocytopenia, further supporting the diagnosis of cirrhosis.  Ultrasound imaging of the abdomen confirms the presence of ascites and reveals a nodular liver consistent with cirrhosis.  Diagnostic paracentesis is planned to evaluate the ascitic fluid for infection (spontaneous bacterial peritonitis) and to determine the serum-ascites albumin gradient (SAAG).  The patient's current condition is consistent with ICD-10 code K74.30, Cirrhosis of liver without ascites, alcoholic.  Given the presence of ascites, code K70.30, Alcoholic cirrhosis of liver with ascites, may be more appropriate pending paracentesis results.  Treatment plan includes sodium restriction, diuretics (spironolactone and furosemide) for ascites management, and ongoing monitoring of liver function and complications such as hepatic encephalopathy and variceal bleeding.  Referral to hepatology for further evaluation and consideration for liver transplantation will be discussed with the patient.  Patient education regarding alcohol cessation and management of cirrhosis complications has been provided.
Cirrhosis of Liver with Ascites - AI-Powered ICD-10 Documentation