Precise medical data entry and the resultant medical coding are important in gastroenterology, since many of the vital organs come under this category and issues involving them could result in serious health conditions and even fatalities.
Cirrhosis Undetected in Hepatitis C Patients – Research
Cirrhosis of the liver is a serious condition, causing liver cancer and eventually failure. While the progression of untreated Hepatitis C inevitably ends up with cirrhosis, many Hepatitis C patients are not diagnosed with cirrhosis even if they have it and their medical records or EHR do not reveal it. A recent research carried out on 2788 hepatitis C patients in four major health systems of the nation by Detroit’s Henry Ford Health System and the CDC (US Centers for Disease Control and Prevention) revealed this fact.
The survey showed that 29% of these hepatitis C patients, 2788 of them, were found to have signs of liver damage or cirrhosis, but only 62% of these patients with liver damage, 1727 of them, had any documentation mentioning that in their records. The liver biopsy conducted on them only served to indicate cirrhosis in 661 of the patients. The researchers however conducted a test known as FIB-4 score, a procedure that has been validated but isn’t performed much by clinicians. It has proved to be more effective than a liver biopsy alone since it revealed four times higher prevalence of cirrhosis than the biopsy indicated.
Liver Cirrhosis Under-diagnosed and Undocumented
The conclusion reached was that cirrhosis could be a highly under-diagnosed condition in the population, something which must be set right. Researchers put part of the blame on the liver biopsy test which isn’t conclusive in revealing damage. The FIB-4 score is achieved by calculating liver enzymes of patients along with their platelet counts plus age, and seems to be more effective in revealing the extent of damage. And electronic health records cannot be relied in this regard, if the biopsy is the primary test used to determine the presence and extent of cirrhosis.
- The diagnosis for reimbursement ICD-10-CM code for liver cirrhosis is K74.69.
- The ICD-9 code, that must be used till October 1, 2015, is 571 with sub-variants for the specific conditions of cirrhosis.
- 571.5 denotes cirrhosis without alcohol while alcoholic cirrhosis is denoted by 571.2.
Liver Cancer Undetected
According to Dr. Stuart Gordon, lead researcher in the study, hepatitis C patients sometimes do not realize they have liver cancer. They are also unaware they they’ve developed cirrhosis that has led to the cancer. Gordon says that an ultrasound may not fully reveal the condition – it could only show a slightly enlarged spleen. Platelet count dropping is also an indication of cirrhosis. However, these are subtle indications and more conclusive tests are required.
Improving Diagnosis and Medical Coding for Hepatitis C
As healthcare professionals know, hepatitis C is a viral infection that is curable. It causes the liver to be infected and inflamed and must be monitored and controlled so the cirrhosis or damage does not develop further which could result in liver cancer and ultimately liver failure.
The CDC estimates that 2.7 to 3.9 million people are presently suffering from chronic hepatitis C in the United States, which makes this research quite significant and relevant. It could significantly impact hepatitis C treatment for the better, and make medical data entry and gastroenterology medical coding for the condition more accurate.
