2025 ICD-10-CM code K74.3
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Diseases of the liver - Fibrosis and cirrhosis of liver Diseases of the digestive system Feed
Primary biliary cirrhosis, a chronic liver disease characterized by inflammation and destruction of the bile ducts.
Modifiers are not applicable to ICD-10 codes.
Medical necessity for the diagnosis and management of PBC is established through clinical findings consistent with the disease, such as elevated liver enzymes, positive serologic markers, and imaging or biopsy evidence of bile duct damage and liver fibrosis or cirrhosis.Treatment decisions (e.g., medication, liver transplant) are based on the severity of disease and patient's clinical presentation.
The clinical responsibility for a patient with K74.3 (Primary biliary cirrhosis) would involve a hepatologist (liver specialist), gastroenterologist, or primary care physician. The physician’s responsibilities include diagnosis, management of symptoms, monitoring disease progression, and coordinating treatment, which may involve medication, lifestyle adjustments, and ultimately liver transplantation referral.
In simple words: Primary biliary cirrhosis is a long-term liver disease where the body's immune system mistakenly attacks the bile ducts in the liver. This causes inflammation, scarring, and eventually liver damage. Symptoms can be mild at first and might include tiredness, itching, and yellowing of the skin or eyes.Treatment aims to manage symptoms and slow down the progression of the disease. In advanced cases, a liver transplant may be necessary.
Primary biliary cirrhosis (PBC), also known as primary biliary cholangitis, is a chronic, autoimmune liver disease primarily affecting intrahepatic bile ducts.It's characterized by progressive destruction of the small bile ducts within the liver, leading to cholestasis (impaired bile flow), inflammation, and ultimately fibrosis (scarring) and cirrhosis (severe scarring). The precise cause remains unknown, but an autoimmune mechanism is strongly implicated.Symptoms can be insidious and may include fatigue, pruritus (itching), jaundice, and hepatomegaly (enlarged liver).Diagnosis involves serological testing (antimitochondrial antibodies), liver biopsy, and imaging studies.Treatment focuses on managing symptoms, slowing disease progression (e.g., ursodeoxycholic acid), and liver transplantation in advanced cases.
Example 1: A 55-year-old female presents with fatigue, pruritus, and elevated liver enzymes.Laboratory tests reveal positive antimitochondrial antibodies, consistent with PBC.Liver biopsy confirms the diagnosis. The physician initiates treatment with ursodeoxycholic acid and monitors the patient's liver function., A 60-year-old male with known PBC experiences a worsening of jaundice and ascites.Imaging studies show advanced liver fibrosis and cirrhosis.The physician determines that liver transplantation is the necessary next step and initiates the referral process., A 48-year-old female with a history of PBC is admitted to the hospital with acute cholangitis.Intravenous antibiotics and supportive care are administered, and the patient's condition improves after a few days of treatment. The physician continues to monitor the patient's condition and adjusts the medication regimen as needed.
Detailed patient history, including symptoms, duration, and progression; physical examination findings; results of laboratory tests (liver function tests, antimitochondrial antibodies); imaging studies (ultrasound, CT, MRI); liver biopsy report (if performed); details of treatments administered and patient response; and any complications experienced.
** Accurate coding of K74.3 requires careful review of the clinical documentation to ensure that the diagnosis is appropriately supported.Differentiate from other liver diseases, such as primary sclerosing cholangitis (K83.0), to ensure proper code selection.
- Revenue Code: Revenue codes will vary based on the specific services rendered and the payer. Consult your payer's guidelines for appropriate revenue codes.
- RVU: RVUs are not applicable to ICD-10 codes.RVUs are assigned to CPT and HCPCS codes for procedural and technical services.
- Global Days: Not applicable to ICD-10 codes.
- Payment Status: Active
- Modifier TC rule: Not applicable to ICD-10 codes.
- Fee Schedule: Not applicable to ICD-10 codes.
- Specialties:Gastroenterology, Hepatology
- Place of Service:Office, Hospital (Inpatient and Outpatient), Ambulatory Surgical Center