ICD-10 Coding for Hepatic Function Panel(R94.5, K70.1)
Complete ICD-10-CM coding and documentation guide for Hepatic Function Panel. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hepatic Function Panel
R94.5Primary Range
Abnormal results of liver function studies
Used when liver function tests are abnormal without a definitive diagnosis.
Diseases of liver
Includes specific liver diseases that may be identified through hepatic function tests.
Abnormal serum enzyme levels
Used for elevated liver enzymes when specific liver disease is not diagnosed.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R94.5 | Abnormal results of liver function studies | When liver function tests are abnormal and no specific liver disease is diagnosed. |
|
| K70.1 | Alcoholic hepatitis | When there is clinical evidence of hepatitis and a history of significant alcohol use. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for hepatic function panel
Essential facts and insights about Hepatic Function Panel
Primary ICD-10-CM Codes for hepatic function panel
Decision Criteria
clinical Criteria
- Abnormal liver function tests without a specific diagnosis
documentation Criteria
- Presence of symptoms like jaundice or ascites
Applicable To
- Abnormal liver function tests
Excludes
- Specific liver diseases (K70-K77)
Clinical Validation Requirements
- ALT >40 U/L (M), >35 U/L (F)
- Presence of symptoms like jaundice or ascites
Code-Specific Risks
- Using without supporting symptoms or etiology
Coding Notes
- Ensure documentation supports abnormal LFTs without a definitive diagnosis.
K70.1 - Alcoholic hepatitis
When there is clinical evidence of hepatitis and a history of significant alcohol use.
Applicable To
- Alcohol-induced liver inflammation
Excludes
- Non-alcoholic liver diseases
Clinical Validation Requirements
- AST:ALT ratio ≥2:1
- Documented alcohol intake >3 drinks/day
Coding Notes
Ensure alcohol use is documented and clinically relevant.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Alcoholic hepatitis
K70.1Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hepatic Function Panel to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R94.5.
Impact
Clinical: Inadequate information for diagnosis, Regulatory: Non-compliance with documentation standards, Financial: Potential claim denials
Mitigation Strategy
Use specific terms like 'elevated ALT' or 'jaundice', Link symptoms to lab results
Impact
Reimbursement: May lead to claim denials if not supported by symptoms., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Ensure documentation includes symptoms like jaundice or ascites.
Impact
Reimbursement: Potential for claim rejections due to insufficient documentation., Compliance: Risk of audits and penalties., Data Quality: Misleading data on patient alcohol use and liver condition.
Mitigation Strategy
Document alcohol use and clinical signs of hepatitis.
Impact
Billing individual tests instead of the panel can lead to audits.
Mitigation Strategy
Use CPT 80076 for the complete panel.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Hepatic Function Panel, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hepatic Function Panel
Use these documentation templates to ensure complete and accurate documentation for Hepatic Function Panel. These templates include all required elements for proper coding and billing.
Patient with elevated liver enzymes
Specialty: GastroenterologyRequired Elements
- Patient symptoms
- Liver enzyme levels
- Potential etiologies
- History of alcohol or drug use
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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