Find comprehensive information on Nonalcoholic Steatohepatitis NASH diagnosis, including ICD-10-CM codes K75.81 and K75.89, clinical documentation requirements, liver biopsy interpretation, medical coding guidelines, and patient care management strategies. Learn about NASH staging, fibrosis scores, and relevant laboratory tests like ALT, AST, and GGT. Explore resources for healthcare professionals covering NASH treatment options, differential diagnosis considerations, and the latest research updates on this progressive liver disease.
Also known as
Nonalcoholic steatohepatitis (NASH)
Liver inflammation and damage due to fat buildup, not alcohol.
Other specified liver diseases
Covers other specific liver conditions not classified elsewhere.
Fatty liver, not elsewhere classified
General category for fatty liver disease without specific cause.
Disorders of lipoid metabolism
May be relevant if NASH is related to lipid metabolic issues.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is it confirmed NASH?
Yes
Is fibrosis present?
No
Do not code NASH. Code underlying condition or signs/symptoms.
When to use each related code
| Description |
|---|
| Nonalcoholic fatty liver disease with inflammation and damage. |
| Nonalcoholic fatty liver disease without inflammation or damage. |
| Advanced scarring of the liver due to various causes. |
Coding K75.81 without staging or activity documentation leads to inaccurate severity reflection and reimbursement issues. CDI crucial for specificity.
Overlooking common NASH comorbidities like diabetes, hypertension, and dyslipidemia impacts risk adjustment and quality metrics. Thorough chart review essential.
Missing or inadequate documentation to support NASH diagnosis (e.g., imaging, biopsy) poses audit risks. CDI should query physicians for clarification.
Q: What are the most effective non-invasive diagnostic tests for confirming Nonalcoholic Steatohepatitis (NASH) in patients with suspected NAFLD?
A: While liver biopsy remains the gold standard for confirming NASH diagnosis, several non-invasive tests are increasingly used to assess disease severity and reduce the need for biopsy. These include transient elastography (e.g., FibroScan) to assess liver stiffness and controlled attenuation parameter (CAP) for steatosis quantification. Serum biomarkers such as the Enhanced Liver Fibrosis (ELF) test and the NAFLD Fibrosis Score can also help risk-stratify patients. Imaging modalities like magnetic resonance elastography (MRE) provide further information about fibrosis stage. Selecting the most appropriate non-invasive test depends on individual patient characteristics and clinical context. Explore how these diagnostic tools can be integrated into your clinical practice for accurate and efficient NASH diagnosis. Consider implementing a diagnostic algorithm that incorporates these non-invasive tests to improve patient care and reduce the reliance on liver biopsy.
Q: How can I differentiate Nonalcoholic Steatohepatitis (NASH) from simple steatosis (NAFLD) in a clinical setting, considering overlapping symptoms and risk factors?
A: Differentiating NASH from simple steatosis can be challenging due to their shared risk factors and often asymptomatic nature. Key differentiators include evidence of hepatocyte injury (e.g., elevated ALT/AST levels) and inflammation, which are characteristic of NASH but not present in simple steatosis. Advanced imaging techniques like MRE and transient elastography can help assess fibrosis and steatosis grade, respectively, providing crucial information for distinguishing NASH. Furthermore, evaluating for the presence of metabolic syndrome components (e.g., dyslipidemia, hypertension, type 2 diabetes) and incorporating serum biomarkers can help stratify patients and inform clinical decision-making. Learn more about the distinct histopathological features of NASH and simple steatosis to enhance your diagnostic accuracy. Consider implementing a comprehensive assessment strategy that incorporates clinical, biochemical, and imaging data for precise differentiation between NASH and NAFLD.
Patient presents with suspected nonalcoholic steatohepatitis (NASH), a form of nonalcoholic fatty liver disease (NAFLD). Clinical findings include elevated liver enzymes (AST, ALT), possible hepatomegaly on physical exam, and complaints of fatigue, right upper quadrant discomfort, or nonspecific abdominal pain. Patient denies significant alcohol consumption, typically less than 2 drinks per week (women) or 3 drinks per week (men). Metabolic risk factors, such as obesity, type 2 diabetes mellitus, dyslipidemia (elevated triglycerides, low HDL cholesterol), and metabolic syndrome, were noted. Imaging studies, such as abdominal ultrasound, may reveal hepatic steatosis. Further evaluation with liver biopsy may be considered for definitive diagnosis and staging of fibrosis to assess disease severity. Differential diagnosis includes alcoholic fatty liver disease, viral hepatitis, autoimmune hepatitis, and drug-induced liver injury. Initial management includes lifestyle modifications, focusing on weight loss through diet and exercise, optimizing diabetes control, and managing dyslipidemia. Pharmacological interventions may be considered for patients with advanced fibrosis, with ongoing clinical trials evaluating new treatment options. Patient education regarding disease progression, potential complications including cirrhosis and hepatocellular carcinoma, and the importance of adherence to treatment recommendations was provided. Follow-up with hepatology is scheduled to monitor disease progression and adjust treatment as needed. ICD-10 code K75.81, Nonalcoholic steatohepatitis (NASH), is documented.