Home Health ICD-9/ICD-10 Alert

Question: I have a question that has puzzled me for some time. What is the correct way to code "end stage liver disease due to cirrhosis from hepatitis C and remote history of alcoholism"?

Answer: To begin coding for this patient, you'll need to locate a code for your patient's end stage liver disease due to cirrhosis of the liver caused by hepatic C. When you reference "disease; liver; end stage; due to hepatitis" in the alphabetic index of your coding manual, you'll be directed to "see hepatitis." So for this patient, you would list 070.54 (Chronic hepatitis C without hepatic coma) for his end stage liver disease.

Next, you'll want to code for your patient's cirrhosis of the liver. Only 20-30 percent of those with Hepatitis C progresses to cirrhosis. The diagnostic statement links the cause of your patient's cirrhosis of the liver to both his history of alcoholism and his hepatitis. Use 571.5 (Cirrhosis of the liver without mention of alcohol) for cirrhosis related to the hepatitis C and 571.2 (Alcoholic cirrhosis of liver) for cirrhosis related to alcoholism. Because the physician's documentation indicates both causes for your patient's cirrhosis, you can list both 571.5 and 571.2.