Chronic Liver Disease: Causes, Treatment, Documentation And Coding

Chronic liver disease, otherwise known as cirrhosis, is the last stage of liver disease. It is the condition which replaces healthy liver tissues with scar tissue which causes permanent damage to the liver. The overuse of alcohol, diseases caused by viruses like hepatitis; fatty liver caused by obesity, cholesterol; and so forth may result in chronic liver disease. Gastroenterology physicians can rely on a gastroenterology medical billing company for accurate filing of medical claims. There are a lot of changes happening in medical coding every now and then; so medical coders in medical billing and coding companies need to stay updated with such new changes so as to ensure a higher level of coding accuracy.

Detection of Disease

The early detection of cirrhosis aids in complete curing of the disease. Diagnostic procedures such as blood test and liver biopsy help to detect chronic liver disease. Procedures like CT scan, MRI scan, or ultrasound help the doctors understand the current condition of patients through images. If the condition has already entered into the chronic stage, then physicians may recommend liver transplantation as the last resort.

Ensuring Proper Medical Documentation

Reimbursement rules, regulations, payer policies and the medical codes frequently undergo changes. So, the services of an experienced medical billing and coding service could help you receive accurate reimbursement. Since they keep abreast with the changes introduced to medical coding, they can prepare records with high precision by including the latest changes. If a physician doesn’t have an in-house medical coding team, then he/she can depend upon an experienced medical billing and coding company for preparing accurate medical claims to submit to health insurers.

Challenges in Coding Cirrhosis

Gastroenterologists face a lot of challenges when coding for medical and surgical procedures. The major concerns include incorrect documentation, inadequate knowledge about E/M guidelines (Evaluation and Management), incorrect use of modifiers, wrong use of ICD-10 or CPT codes, eligibility verification, and determining medical necessity. An in-house billing team or an outsourcing medical billing and coding company would help physicians efficiently address such concerns.

ICD-10 Codes for Chronic Liver Disease

Chronic liver disease is classified into different categories such as alcoholic liver disease, toxic liver disease, hepatic failure, chronic hepatitis, fibrosis and cirrhosis of liver, other inflammatory liver diseases; other diseases of liver, liver disorders in diseases classified elsewhere, which has codes listed from K70 to K77.

K70 – Alcoholic liver disease

• K70.0 Alcoholic fatty liver
• K70.1 Alcoholic hepatitis
• K70.2 Alcoholic fibrosis and sclerosis of liver
• K70.3 Alcoholic cirrhosis of liver
• K70.4 Alcoholic hepatic failure
• K70.9 Alcoholic liver disease, unspecified

K71 Toxic liver disease

• K71.0 Toxic liver disease with cholestasis
• K71.1 Toxic liver disease with hepatic necrosis
• K71.2 Toxic liver disease with acute hepatitis
• K71.3 Toxic liver disease with chronic persistent hepatitis
• K71.4 Toxic liver disease with chronic lobular hepatitis
• K71.5 Toxic liver disease with chronic active hepatitis
• K71.6 Toxic liver disease with hepatitis, not elsewhere classified
• K71.7 Toxic liver disease with fibrosis and cirrhosis of liver
• K71.8 Toxic liver disease with other disorders of liver
• K71.9 Toxic liver disease, unspecified

K72 Hepatic Failure

• K72.0 Acute and sub acute hepatic failure
• K72.1 Chronic hepatic failure
• K72.9 Hepatic failure, unspecified

K73 Chronic Hepatitis

• K73.0 Chronic persistent hepatitis, not elsewhere classified
• K73.1 Chronic lobular hepatitis, not elsewhere classified
• K73.2 Chronic active hepatitis, not elsewhere classified
• K73.8 Other chronic hepatitis, not elsewhere classified
• K73.9 Chronic hepatitis, unspecified

K74 Fibrosis and cirrhosis of Liver

• K74.0 Hepatic fibrosis
• K74.1 Hepatic sclerosis
• K74.2 Hepatic fibrosis with hepatic sclerosis
• K74.3 Primary biliary cirrhosis
• K74.4 Secondary biliary cirrhosis
• K74.5 Biliary cirrhosis, unspecified
• K74.6 Other and unspecified cirrhosis of liver

K75 Other Inflammatory Liver Disease

• K75.0 Abscess of liver
• K75.1 Phlebitis of portal vein
• K75.2 Nonspecific reactive hepatitis
• K75.3 Granulomatous hepatitis, not elsewhere classified
• K75.4 Autoimmune hepatitis
• K75.8 Other specified inflammatory liver diseases
• K75.9 Inflammatory liver disease, unspecified

K76 Other Diseases of Liver

• K76.0 Fatty (change of) liver, not elsewhere classified
• K76.1 Chronic passive congestion of liver
• K76.2 Central hemorrhagic necrosis of liver
• K76.3 Infarction of liver
• K76.4 Peliosis hepatis
• K76.5 Hepatic veno-occlusive disease
• K76.6 Portal hypertension
• K76.7 Hepatorenal syndrome
• K76.8 Other specified diseases of liver
• K76.9 Liver disease, unspecified

K77 Liver Disorders in Diseases Classified Elsewhere

• E85 amyloidosis
• A50.0 Early congenital syphilis, symptomatic
• A50.5 Other late congenital syphilis, symptomatic
• P37.1 Congenital toxoplasmosis
• B27.0 Gammaherpesviral mononucleosis
• B27.9 Infectious mononucleosis, unspecified
• B65.0 Schistosomiasis due to Schistosoma haematobium [urinary schistosomiasis]
• B65.9 Schistosomiasis, unspecified

CPT Codes for Liver Transplantation Procedures

Liver transplantation is the last resort for treating chronic liver disease. According to the American Academy of Professional Coders, the CPT code for liver transplantation listed from 47133 to 47147.

47133 Donor hepatectomy, (including cold preservation), from cadaver donor

47135 Liver allotransplantation; orthotopic, partial or whole, from cadaver or living donor, any age

47140 Donor hepatectomy (including cold preservation), from living donor; left lateral segment only (segments II and III)

47141 Donor hepatectomy (including cold preservation), from living donor; total left lobectomy (segments II, III, IV)

47142 Donor hepatectomy (including cold preservation), from living donor; total right lobectomy (segments V, VI, VII and VIII)

47143 Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; without trisegment or lobe split

47144 Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with trisegment split of whole liver graft into 2 partial liver grafts (ie, left lateral segment [segments II and III] and right trisegment [segments I and IV through VIII])

47145 Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to prepare the vena cava, portal vein, hepatic artery, and common bile duct for implantation; with lobe split of whole liver graft into 2 partial liver grafts (ie, left lobe [segments II, III, and IV] and right lobe [segments I and V through VIII])

47146 Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous anastomosis, each

47147 Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial anastomosis, each

Medical coding is a crucial as well as tedious process in the medical billing cycle. The medical coder has to be very cautious while preparing the records. Busy physicians would find the services of a medical billing and coding company a practical and efficient option. With the timely services of a medical billing firm, physicians can ensure prompt filing of their claims and accurate reimbursement from payers.