Find comprehensive information on steatohepatitis (NASH, fatty liver disease), including clinical documentation tips, ICD-10-CM coding guidelines (K75.81, K75.9), medical billing resources, and diagnostic criteria. Learn about the latest treatment options, liver function tests (LFTs), and histological findings associated with nonalcoholic steatohepatitis and alcoholic steatohepatitis. This resource supports healthcare professionals in accurately documenting and coding steatohepatitis for optimal patient care and reimbursement.
Also known as
Nonalcoholic steatohepatitis
Liver inflammation and fat buildup, not due to excessive alcohol use.
Alcoholic liver disease
Liver damage caused by excessive alcohol consumption, can include steatohepatitis.
Other specified liver diseases
Includes other forms of steatohepatitis not classified elsewhere.
Other disorders of purine and pyrimidine metabolism
May include metabolic conditions causing hepatic steatosis or steatohepatitis.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is the steatohepatitis alcoholic?
Yes
Code K70.1 Alcoholic steatohepatitis
No
Is it due to a drug or other external agent?
When to use each related code
| Description |
|---|
| Fatty liver with inflammation |
| Non-alcoholic fatty liver disease |
| Alcoholic steatohepatitis |
Coding NASH without specifying alcoholic vs. nonalcoholic (K75.81 vs K75.84) leads to inaccurate data and potential DRG misassignment.
Failing to code common NASH comorbidities like diabetes, obesity, and hypertension impacts risk adjustment and reimbursement.
Lack of proper clinical documentation supporting NASH severity and etiology hinders accurate coding and audit defense.
Q: What are the most effective non-invasive diagnostic tests for differentiating NASH from simple steatosis in patients with suspected NAFLD?
A: Differentiating nonalcoholic steatohepatitis (NASH) from simple steatosis is crucial for determining prognosis and treatment strategies in patients with nonalcoholic fatty liver disease (NAFLD). While liver biopsy remains the gold standard, several non-invasive tests are emerging as valuable tools. These include serum biomarkers such as the Enhanced Liver Fibrosis (ELF) test and the FIB-4 index, which can assess the degree of liver fibrosis. Imaging modalities like transient elastography (FibroScan) and magnetic resonance elastography (MRE) can also non-invasively evaluate liver stiffness, correlating with fibrosis stage. Furthermore, novel serum markers targeting NASH-specific pathways, like CK-18 fragments, are being investigated. Combining these non-invasive tests can enhance diagnostic accuracy, minimizing the need for biopsy in many cases. Consider implementing a multi-modal approach using a combination of serum biomarkers and imaging studies for improved risk stratification. Explore how these diagnostic tools can be integrated into your clinical practice for more efficient and patient-friendly NASH diagnosis.
Q: How do I manage a patient with biopsy-proven NASH and significant fibrosis (stage 3 or 4) who also has type 2 diabetes and cardiovascular disease?
A: Managing a patient with biopsy-proven NASH, advanced fibrosis (stage 3 or 4), type 2 diabetes, and cardiovascular disease requires a multidisciplinary approach focused on mitigating both liver-related and cardiovascular risks. Prioritize optimizing glycemic control and managing cardiovascular risk factors such as hypertension and dyslipidemia according to established guidelines. Weight loss through lifestyle interventions (diet and exercise) is crucial for improving both NASH and metabolic health. Pharmacotherapy for NASH, such as GLP-1 receptor agonists like semaglutide and tirzepatide, may be beneficial in improving liver histology and fibrosis, while also addressing diabetes management. Given the advanced fibrosis, careful monitoring for complications like hepatocellular carcinoma (HCC) with regular ultrasound surveillance is essential. Consider a referral to a hepatologist for further evaluation and management of advanced fibrosis. Learn more about the latest clinical trials investigating novel therapies for NASH with advanced fibrosis to stay updated on emerging treatment options.
Patient presents with suspected steatohepatitis, evidenced by persistent elevation in liver enzymes (ALT, AST) and imaging findings suggestive of fatty liver disease. Symptoms include fatigue, right upper quadrant abdominal discomfort, and hepatomegaly on physical examination. Differential diagnosis includes nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), alcoholic fatty liver disease (AFLD), and other causes of chronic liver disease. Patient reports a history of [Insert relevant patient history e.g., obesity, type 2 diabetes mellitus, dyslipidemia, alcohol use]. Laboratory results show elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and potentially elevated gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP). Imaging studies such as ultrasound, CT scan, or MRI of the abdomen reveal hepatic steatosis. Liver biopsy may be considered for definitive diagnosis and to assess the degree of inflammation and fibrosis. Diagnosis of steatohepatitis is based on clinical presentation, laboratory findings, imaging results, and potentially histopathological examination. Treatment plan includes lifestyle modifications such as weight loss, dietary changes focusing on a healthy balanced diet, and increased physical activity. Pharmacological interventions may be considered depending on the underlying cause and severity of the disease. Patient education regarding disease management, potential complications including cirrhosis and hepatocellular carcinoma, and the importance of follow-up care is crucial. ICD-10 code K75.81 (other specified inflammatory liver diseases) or K70.0 (alcoholic fatty liver) may be appropriate depending on the etiology. CPT codes for relevant procedures, such as liver biopsy (47122) or abdominal imaging, should be documented accordingly. Follow-up appointment scheduled in [timeframe] to monitor disease progression and response to treatment.