what is the icd 10 code for elevated lft

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20-03-2025

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What is the ICD-10 Code for Elevated LFTs? Understanding Liver Function Tests and Coding

There isn't a single ICD-10 code for "elevated LFTs" (liver function tests). This is because elevated LFTs are a symptom or finding, not a diagnosis. The specific ICD-10 code used depends entirely on the underlying cause of the elevated liver enzymes. To accurately code, clinicians must identify and code the underlying disease or condition responsible for the abnormal liver function test results.

This article will delve into the complexities of interpreting elevated LFTs, the various conditions that can cause them, and how to determine the appropriate ICD-10 code in each scenario.

Understanding Liver Function Tests (LFTs)

Liver function tests are a panel of blood tests that assess the health of the liver. Several enzymes and proteins are measured, including:

• Alanine aminotransferase (ALT): Primarily found in the liver, elevated ALT levels usually indicate liver damage.
• Aspartate aminotransferase (AST): Present in the liver, heart, and muscles, elevated AST levels can suggest liver damage, but also heart or muscle problems. The ratio of ALT to AST can provide clues about the cause of liver damage.
• Alkaline phosphatase (ALP): Found in the liver, bones, and intestines, elevated ALP levels can indicate liver or bone disease.
• Gamma-glutamyl transferase (GGT): Primarily found in the liver and bile ducts, elevated GGT levels suggest liver or bile duct damage.
• Bilirubin: A breakdown product of hemoglobin, elevated bilirubin levels indicate impaired liver function or bile duct blockage. This can manifest as jaundice (yellowing of the skin and eyes).
• Albumin: A protein produced by the liver, low albumin levels indicate impaired liver function.
• Prothrombin time (PT): Measures how long it takes blood to clot, prolonged PT indicates impaired liver function.

Conditions Associated with Elevated LFTs

A wide range of conditions can cause elevated LFTs. These include:

• Alcoholic liver disease: Chronic alcohol consumption leads to inflammation and damage to the liver, resulting in elevated ALT, AST, and GGT. ICD-10 codes would depend on the severity: K70 (Alcoholic fatty liver disease), K70.0 (Alcoholic steatosis), K70.1 (Alcoholic steatohepatitis), K70.3 (Alcoholic hepatitis), K70.4 (Alcoholic fibrosis), K70.9 (Alcoholic liver disease, unspecified).
• Non-alcoholic fatty liver disease (NAFLD): A common condition often associated with obesity, diabetes, and metabolic syndrome. It ranges from simple steatosis (fatty liver) to non-alcoholic steatohepatitis (NASH), which can lead to cirrhosis. Codes: K76.0 (Nonalcoholic fatty liver disease) and K76.1 (Nonalcoholic steatohepatitis).
• Viral hepatitis (A, B, C): Viral infections can cause significant liver damage. Codes vary based on the specific virus: B16, B17, B18 (Hepatitis A, B, C respectively). Further sub-codes denote acute, chronic, or other specifications.
• Autoimmune hepatitis: The body's immune system attacks the liver. Codes: K74.0-K74.3 (various types of autoimmune hepatitis)
• Drug-induced liver injury (DILI): Certain medications can cause liver damage. The code will depend on the specific drug and the severity of the injury. There are often specific codes that capture drug-induced liver injuries, which should be used when appropriate.
• Cirrhosis: Scarring of the liver, often caused by chronic liver diseases. Codes: K70.3 (Alcoholic hepatitis can lead to cirrhosis), K74.3 (Autoimmune hepatitis can lead to cirrhosis), K74.6 (Other chronic hepatitis can lead to cirrhosis) amongst others, depending on the cause.
• Hepatocellular carcinoma (HCC): Liver cancer. Code: C22.0
• Cholestasis: Impaired bile flow. Codes depend on the cause: may be coded alongside other conditions such as gallstones, K80, or other biliary disorders.
• Genetic liver disorders: Several inherited conditions affect liver function. Specific codes are available depending on the particular disorder.
• Heart failure: Severe heart failure can lead to liver congestion (congestive hepatopathy), this will require codes related to heart failure (I50) in conjunction with the liver involvement.
• Primary biliary cholangitis (PBC): A chronic liver disease that leads to destruction of the bile ducts. K82.0
• Primary sclerosing cholangitis (PSC): Another chronic liver disease involving inflammation and scarring of the bile ducts. K82.1

Coding Considerations:

• Specificity is key: The more precise the diagnosis, the more accurate the ICD-10 code. A simple "elevated LFTs" is insufficient for coding.
• Underlying cause: The code should reflect the underlying condition causing the elevated liver enzymes.
• Severity: Some codes specify the severity of the disease (e.g., acute vs. chronic).
• Multiple codes: It may be necessary to use multiple codes if the patient has several conditions contributing to elevated LFTs.
• Documentation: Comprehensive clinical documentation is essential for accurate coding. The physician's notes should clearly state the diagnosis and any supporting evidence.

Example Scenarios and Corresponding Codes:

• Patient presents with elevated ALT and AST due to chronic alcohol abuse and biopsy confirms alcoholic hepatitis: K70.3 (Alcoholic hepatitis)
• Patient with elevated ALP and GGT, diagnosed with gallstones causing obstruction: K80 (Cholelithiasis) alongside codes for any complications.
• Patient with elevated ALT, AST, and bilirubin, diagnosed with Hepatitis C: B18.2 (Chronic Hepatitis C)

Conclusion:

Elevated liver function tests are not a diagnosis in themselves, but rather a sign of underlying liver dysfunction. Accurately coding elevated LFTs requires a thorough understanding of the patient's clinical presentation, diagnostic investigations (including imaging and biopsies when indicated), and the identification of the underlying cause. The appropriate ICD-10 code must reflect the specific disease or condition responsible for the abnormal liver function test results. Always consult the latest ICD-10-CM manual and seek guidance from qualified coding professionals for complex cases. This information is for educational purposes and does not constitute medical or coding advice. Always rely on the professional judgment of a qualified healthcare provider for diagnosis and treatment.