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R94.5
ICD-10-CM
Hepatic Function Panel

Understand hepatic function panel (HFP) results with this guide for healthcare professionals. Learn about LFTs, liver function tests, ALT, AST, ALP, bilirubin, albumin, and GGT levels in clinical documentation. Explore medical coding for HFP, abnormal liver function tests, and liver disease diagnosis. Improve your understanding of hepatic health, liver panel interpretation, and best practices for patient care.

Also known as

Liver Function Test
LFT Panel

Diagnosis Snapshot

Key Facts
  • Definition : Blood tests evaluating liver function, diagnosing liver disease, and monitoring treatment.
  • Clinical Signs : Jaundice, abdominal pain, fatigue, nausea, dark urine, pale stools.
  • Common Settings : Primary care clinics, hospitals, gastroenterology offices, hepatology centers.

Related ICD-10 Code Ranges

Complete code families applicable to AAPC R94.5 Coding
R16-R19

Hepatomegaly and liver function abnormality

Abnormal liver size or function tests.

K70-K77

Diseases of liver

Covers various liver diseases impacting function.

R74.0

Abnormal liver function tests NOS

Indicates nonspecific abnormal liver function.

Code-Specific Guidance

Decision Tree for

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

Is the hepatic panel ordered for monitoring a pre-existing condition?

  • Yes

    What condition is being monitored?

  • No

    Are there abnormal findings?

Code Comparison

Related Codes Comparison

When to use each related code

Description
Hepatic Function Panel
Acute Hepatitis
Cirrhosis

Documentation Best Practices

Documentation Checklist
  • Hepatic Function Panel documentation: ICD-10 codes, signs/symptoms
  • Document specific LFTs: ALT, AST, ALP, total bilirubin levels
  • Record patient history, including relevant medications, alcohol use
  • Note physical exam findings: jaundice, ascites, hepatomegaly
  • Justification for HFP testing: e.g., liver disease monitoring

Coding and Audit Risks

Common Risks
  • Unspecified Diagnosis

    Coding hepatic function panel without specifying the underlying condition leading to the test can lead to claim denials and inaccurate data.

  • Unbundling Risk

    Incorrectly billing individual hepatic panel components separately instead of using the comprehensive panel code can trigger audits for overcharging.

  • Medical Necessity

    Lack of proper documentation supporting the medical necessity of a hepatic function panel can raise red flags for potential inappropriate utilization and fraud.

Mitigation Tips

Best Practices
  • Document precise symptoms for accurate HFP coding (ICD-10-CM).
  • Ensure medical necessity for HFP tests. HCC/risk adjustment.
  • Clear liver disease stage in notes improves CDI, RAF scores.
  • Standardize HFP documentation for compliant billing (CPT codes).
  • Regular training on HFP guidelines for coders, CDI specialists.

Clinical Decision Support

Checklist
  • Verify ICD-10-CM codes (e.g., K70-K77, R17)
  • Confirm documented signs/symptoms (jaundice, fatigue)
  • Review medications impacting liver function
  • Check for prior liver disease/tests in patient history
  • Correlate LFT results with clinical picture for diagnosis

Reimbursement and Quality Metrics

Impact Summary
  • Hepatic Function Panel reimbursement tied to CPT 80076, impacting claim denial rates.
  • Coding accuracy for diagnosis impacts appropriate reimbursement under Medicare and Medicaid.
  • Hospital reporting of Hepatic Function Panel data impacts quality metrics related to liver disease management.
  • Accurate ICD-10 coding linked to Hepatic Function Panel crucial for appropriate DRG assignment and hospital revenue.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code all LFTs in panel
  • Document indication for HFP
  • ICD-10-CM guides diagnosis
  • Review abnormal results, add specs
  • CPT codes for individual tests

Documentation Templates

Patient presents for evaluation of liver function due to [reason for testing; e.g., abnormal liver enzymes on routine bloodwork, fatigue, abdominal pain, jaundice, suspected liver disease].  A comprehensive metabolic panel (CMP) and hepatic function panel (also known as liver function tests or LFTs) were ordered to assess liver health and identify potential underlying etiologies.  The hepatic panel includes tests for albumin, total protein, alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin (total and direct), and gamma-glutamyl transferase (GGT).  Results of the hepatic panel reveal [specific results; e.g., elevated ALT and AST, normal ALP, mildly elevated bilirubin, indicating possible hepatocellular injury].  Differential diagnoses include viral hepatitis, non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease, drug-induced liver injury, autoimmune hepatitis, and other less common liver disorders.  Patient's medical history includes [relevant medical history; e.g., type 2 diabetes, hyperlipidemia, no history of alcohol abuse]. Current medications include [list medications].  Physical examination findings include [relevant physical exam findings; e.g., normal abdominal exam, no hepatomegaly or splenomegaly, no jaundice].  Based on the patient's presentation, laboratory findings, and medical history, the preliminary diagnosis is [preliminary diagnosis; e.g., suspected NAFLD].  Further investigation with [further tests; e.g., hepatitis panel, liver ultrasound, consultation with gastroenterology] is recommended to confirm the diagnosis and guide treatment.  Patient education provided on liver health, lifestyle modifications including diet and exercise, and the importance of follow-up care.  ICD-10 code[s] [insert relevant ICD-10 code(s); e.g., K76.0] assigned.  CPT code[s] for the hepatic function panel [insert relevant CPT code(s); e.g., 80076] documented for billing purposes.
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