Liver failure w/wo hepatic encephalopathy, acute or subacute NOS

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ICD10 Diagnosis
Dx: Liver failure w/wo hepatic encephalopathy, acute or subacute NOS
ICD10 code: K72.0
Pre-ICD10 counterpart: Fulminant Hepatic Failure, Non Fulminant Hepatic Failure
Charlson/ALERT Scale: Moderate or severe liver disease
APACHE Como Component: Liver
APACHE Acute Component: none
Start Date:
Stop Date:
Data Dependencies(Reports/Indicators/Data Elements): No results
External ICD10 Documentation

This diagnosis is a part of ICD10 collection.

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    • 2019-01-01
    • 2999-12-31
    • K72.0
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Additional Info

  • This is the code to use for fulminant OR acute OR subacute liver failure (with or without hepatic encephalopathy) that is NOT due to ethanol or another drug/toxin.
  • 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
  • Also code the cause of the liver failure, if known

Includes liver failure due to

  • Liver cirrhosis is NOT the same thing as liver failure. They can occur alone, or together.
    • Liver cirrhosis, NOS rarely has time to develop in fulminant or acute or even subacute liver failure.

Definitions

  • Fulminant hepatic failure (acute liver 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 (subacute hepatic failure).
  • Subacute hepatic failure (SAHF) is now characterized by gradual deterioration of hepatic function between 8 and 24 weeks of onset of jaundice.
  • Non Fulminant Hepatic failure (chronic hepatic failure) - refers to liver failure that has been on a steady decline, occurring 24 weeks after the onset of liver disease, End of the line due to a chronic underlying known 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

Encephalopathy codes:
Liver disease codes:
Liver failure codes:
cirrhosis codes:

Candidate Combined ICD10 codes

Code the cause if known, e.g. shock liver, Hep B, Hep C, other viral hepatitis, immune-mediated liver diseases, or other causes of liver disease

Related CCI Codes

Data Integrity Checks (automatic list)

none found

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