K74.4

Billable

Secondary biliary cirrhosis

HCC Category Mapping

V28HCC 64 — Cirrhosis of Liver

0.666

V24HCC 28 — Cirrhosis of Liver

0.390

ESRDHCC 28 — Cirrhosis of Liver

0.000

What This Code Means

Cirrhosis of the liver caused by obstruction or damage to the bile ducts from another condition, such as gallstones or strictures.

Coding Tips

•Identify and document the underlying cause of bile duct obstruction or damage when possible
•Distinguish from K74.3 (primary biliary cirrhosis) which is autoimmune in origin

Clinical Significance

Secondary biliary cirrhosis results from chronic bile duct obstruction or damage from external causes, leading to progressive liver scarring and dysfunction. This condition requires treatment of the underlying obstruction and monitoring for cirrhosis complications.

Documentation Requirements

✓Evidence of bile duct obstruction or external biliary tract damage
✓Imaging showing biliary dilation or strictures
✓History of biliary surgery, stones, or strictures
✓Elevated alkaline phosphatase and bilirubin levels
✓Liver biopsy showing portal fibrosis and bile duct proliferation
✓Documentation of underlying obstructive cause
✓Clinical presentation with jaundice or cholestasis
✓Exclusion of primary biliary cirrhosis (negative AMA)

Commonly Confused Codes

K74.3 — Primary biliary cirrhosis is autoimmune rather than obstructive K74.5 — Biliary cirrhosis unspecified when primary vs secondary not documented K83.1 — Bile duct obstruction without established cirrhosis K74.60 — Unspecified cirrhosis when biliary nature not documented K76.6 — Portal hypertension may be consequence but not the primary diagnosis

Code Hierarchy

└K74Fibrosis and cirrhosis of liver └K74.4Secondary biliary cirrhosis

└K74.4Secondary biliary cirrhosis