Liver failure, alcoholic, w/wo hepatic encephalopathy
|Dx:||Liver failure, alcoholic, w/wo hepatic encephalopathy|
|Pre-ICD10 counterpart:||Fulminant Hepatic Failure, Non Fulminant Hepatic Failure, Alcoholic Liver Disease|
|Charlson/ALERT Scale:||Moderate or severe liver disease|
|APACHE Como Component:||Liver|
|APACHE Acute Component:||none|
|External ICD10 Documentation|
This diagnosis is a part of ICD10 collection.
- This is the code to use for any type of alcoholic liver failure: fulminant, acute, subacute, chronic, NOS, with or without hepatic encephalopathy.
- Remember that liver failure is a distinct manifestation of advanced liver disease that can be caused by many different types of liver disease. Elevations (even big elevations) alone of transaminases is not liver failure. In liver failure, there must be evidence of one or both of:
- synthetic dysfunction indicated by coagulopathy (with elevated PT, INR), very low albumin and other plasma proteins
- hepatic encephalopathy
- Liver cirrhosis is NOT the same thing as liver failure. They can occur alone, or together.
- DEFINITION — Fulminant hepatic failure refers to the rapid development of severe liver injury resulting in impaired function and encephalopathy in a person who previously had a normal liver or had well-compensated liver disease. Several definitions of the time course for which liver failure should be considered fulminant have been proposed but are not standard:
- The development of encephalopathy within eight weeks of the onset of symptoms in a patient with a previously healthy liver.
- The appearance of encephalopathy within two weeks of developing jaundice, even in a patient with previous underlying liver dysfunction.
- Patients who have rapid deterioration of liver function with the development of encephalopathy within six months but fall outside the boundaries of the above time intervals are considered to have "subfulminant" hepatic failure.
Fulminant liver failure (FLF), is a rare condition in which rapid deterioration of liver function results in altered mentation and coagulopathy in previously normal individuals. U.S. estimates are placed at approximately 2,000 cases per year. The most prominent causes include drug-induced liver injury, viral hepatitis, autoimmune liver disease, and shock or hypoperfusion; many cases (20 percent) have no discernible cause. Fulminant liver failure often affects young persons and carries a high morbidity and mortality. Prior to transplantation, most series suggested less than 15 percent survival. Currently, overall short-term survival with transplantation is greater than 65 percent. Because of its rarity, FLF has been difficult to study in depth and very few controlled therapy trials have been performed. As a result, standards of intensive care for this condition have not been established.
- Non Fulminant Hepatic failure - refers to liver failure that has been on a steady decline. End of the line due to a chronic underlying know liver disease.
Altered mental status coding guideline
Coding altered mental status in ICD10 can be complex, see ICD10 Guideline for coding altered mental status for more info.
Alternate ICD10s to consider coding instead or in addition
- Codes for other aspects of alcoholic liver disease:
- This is one of several different codes for liver failure:
|Liver failure codes:|
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)