Learn about cirrhotic liver, also known as liver cirrhosis or hepatic cirrhosis. This resource provides information on diagnosis, clinical documentation, and medical coding for healthcare professionals. Find details on ICD-10 codes, symptoms, treatment, and management of cirrhotic liver disease. Improve your clinical documentation and ensure accurate medical coding with this comprehensive guide for liver cirrhosis.
Also known as
Other and unspecified cirrhosis of liver
Covers various cirrhosis types without portal hypertension.
Alcoholic cirrhosis of liver
Cirrhosis specifically caused by excessive alcohol consumption.
Secondary biliary cirrhosis
Cirrhosis resulting from chronic biliary obstruction.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the cirrhosis compensated or decompensated?
Compensated
Is there alcoholic etiology?
Decompensated
Is there alcoholic etiology?
When to use each related code
| Description |
|---|
| Late-stage scarring (fibrosis) of the liver. |
| Liver inflammation, often from viral infection or alcohol. |
| Fatty liver disease not due to excessive alcohol use. |
Coding cirrhosis without specifying the cause (alcoholic, non-alcoholic, etc.) leads to inaccurate reporting and potential DRG misclassification.
Failing to document and code associated conditions like hepatic encephalopathy or ascites impacts severity and resource utilization.
Missing codes for hepatocellular carcinoma (HCC) surveillance in cirrhotic patients can lead to underreporting of quality measures and lost revenue.
Q: What are the most effective strategies for managing ascites in patients with decompensated cirrhotic liver disease?
A: Managing ascites in decompensated cirrhosis requires a multifaceted approach. Sodium restriction (less than 2g/day) is paramount. Diuretic therapy, typically with aldosterone antagonists like spironolactone and loop diuretics such as furosemide, is often initiated, with careful monitoring of electrolyte levels and renal function. Large-volume paracentesis can provide rapid relief for tense ascites, but requires careful consideration of albumin infusion to prevent circulatory dysfunction. For refractory ascites, transjugular intrahepatic portosystemic shunt (TIPS) may be considered, but carries a risk of hepatic encephalopathy. Explore how optimizing fluid management and considering individual patient factors can improve outcomes in decompensated cirrhosis.
Q: How can I differentiate between compensated and decompensated cirrhosis based on clinical presentation and laboratory findings?
A: Differentiating compensated and decompensated cirrhosis hinges on identifying signs of hepatic decompensation. Compensated cirrhosis is often asymptomatic, with potential subtle findings like spider angiomata or palmar erythema. Laboratory abnormalities may include mild elevations in liver enzymes and bilirubin. Decompensated cirrhosis, however, manifests with overt clinical signs such as ascites, variceal bleeding, hepatic encephalopathy, or jaundice. Laboratory markers often show significant derangements in liver function tests, including elevated bilirubin, prolonged prothrombin time, and decreased albumin. Consider implementing a thorough evaluation, including imaging and endoscopic procedures, to accurately stage cirrhosis and guide management decisions. Learn more about the specific diagnostic criteria for each stage of cirrhosis.
Patient presents with symptoms suggestive of cirrhotic liver disease, including fatigue, ascites, and jaundice. Physical examination reveals hepatomegaly and splenomegaly. Laboratory findings demonstrate elevated liver enzymes (AST, ALT, ALP), decreased albumin, prolonged prothrombin time (PT), and thrombocytopenia. Imaging studies (ultrasound, CT abdomen) reveal a nodular liver surface consistent with cirrhosis. The patient's history includes long-term alcohol abuse, a significant risk factor for alcoholic liver cirrhosis. Diagnosis of liver cirrhosis is made based on clinical presentation, laboratory data, and imaging findings. Differential diagnoses considered included non-alcoholic fatty liver disease (NAFLD), hepatitis C, and autoimmune hepatitis. The patient's Model for End-Stage Liver Disease (MELD) score was calculated to assess prognosis and prioritize for liver transplant evaluation. Treatment plan includes management of complications such as ascites with diuretics and paracentesis, esophageal varices screening with endoscopy, nutritional support, and abstinence from alcohol. Patient education provided regarding lifestyle modifications, medication management, and the importance of regular follow-up for monitoring disease progression and potential complications like hepatic encephalopathy and hepatocellular carcinoma. ICD-10 code K74.6 (cirrhosis of liver, unspecified) assigned. Referral to gastroenterology and hepatology specialist initiated. Prognosis discussed with the patient and family.