K74.69 ICD-10-CM Code: Other cirrhosis of liver
HCC Buddy Code Card
Digital ICD-10 code-book layout with official code detail, always-visible risk models, Code Trumping, and Buddy coding guidance.
FY 2026 Apr update / Diseases of the digestive system (K00-K95) / Diseases of liver (K70-K77)
K74.69
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther cirrhosis of liver
Cirrhosis of the liver of a specific type that is not captured by the other cirrhosis codes in the K74 category.
Buddy Insight
Other cirrhosis encompasses specific types of liver cirrhosis not captured by standard categories, representing advanced liver disease requiring specialized management.
CMS-HCC V28
MappedHCC 64
RAF 0.666
CMS-HCC V24
MappedHCC 28
RAF 0.390
ACA/HHS
00
RAF 0
ESRD/PACE
MappedHCC 28
RAF 0.0
RXHCC
00
RAF 0
Code Trumping
Basket needed
Code Book Path
Inclusion Terms
Official- Cryptogenic cirrhosis (of liver)
- Macronodular cirrhosis (of liver)
- Micronodular cirrhosis (of liver)
- Mixed type cirrhosis (of liver)
- Portal cirrhosis (of liver)
Excludes 2
OfficialICD-10-CM does not list Excludes 2 notes for K74.69 in this effective period.
Related Child Codes
Includes
OfficialICD-10-CM does not list Includes notes for K74.69 in this effective period.
Excludes 1
OfficialICD-10-CM does not list Excludes 1 notes for K74.69 in this effective period.
Code First
OfficialICD-10-CM does not list Code First sequencing instructions for K74.69 in this effective period.
Use Additional
OfficialICD-10-CM does not list Use Additional Code instructions for K74.69 in this effective period.
Code Also
OfficialICD-10-CM does not list Code Also instructions for K74.69 in this effective period.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Last updated: FY2026 ICD-10-CM Apr update, Apr 1, 2026 through Sep 30, 2026. CMS-HCC V28 is 100% phased in for payment year 2026.
Is K74.69 an HCC code?
Yes. K74.69 maps to Cirrhosis of Liver under the CMS-HCC V28 risk adjustment model (and Cirrhosis of Liver under V24).
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for K74.69
For K74.69to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically, it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed K74.69 during that encounter, not just copy-forwarded from a problem list.
What This Code Means
K74.69 is the ICD-10-CM diagnosis code for other cirrhosis of liver. Cirrhosis of the liver of a specific type that is not captured by the other cirrhosis codes in the K74 category. K74.69 sits in the ICD-10-CM chapter for diseases of the digestive system (k00-k95), within the section covering diseases of liver (k70-k77).
Under the CMS-HCC V28 risk adjustment model, K74.69 maps to Cirrhosis of Liver (HCC 64) with a community, non-dual, aged base RAF weight of 0.666. Under the older V24 model, K74.69 mapped to the same category but with a base RAF weight of 0.390, V28 recalibrated weights across the entire model. V28 is the CMS-HCC risk adjustment model that reached 100% phase-in for payment year 2026, replacing V24 which was used during the PY2024–PY2025 transition.
Review documentation carefully to identify the specific type of cirrhosis being described. Because K74.69 maps to a payment HCC, the provider's documentation must satisfy MEAT criteria (Monitor, Evaluate, Assess, or Treat) for the encounter to count toward the patient's Medicare Advantage risk adjustment score. When documentation is ambiguous, coders should issue a provider query rather than assume the highest-specificity variant.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for K74.69 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Review documentation carefully to identify the specific type of cirrhosis being described
- •Include the etiology or specific type in the medical record to support this code selection
Clinical Significance
Other cirrhosis encompasses specific types of liver cirrhosis not captured by standard categories, representing advanced liver disease requiring specialized management. This diagnosis indicates significant hepatic dysfunction with high potential for life-threatening complications.
Documentation Requirements
- ✓Histological or radiological evidence of cirrhosis
- ✓Specific documentation of cirrhosis type not fitting other K74 categories
- ✓Clinical manifestations of advanced liver disease
- ✓Laboratory evidence of hepatic synthetic dysfunction
- ✓Portal hypertension or related complications
- ✓Exclusion of alcoholic, biliary, and viral causes
- ✓Evidence of hepatic nodular regeneration and fibrosis
- ✓Specification of the particular cirrhosis type
Commonly Confused Codes
- •K74.60 — Unspecified cirrhosis when specific type not documented
- •K70.30 — Alcoholic cirrhosis when alcohol is the etiology
- •K74.3 — Primary biliary cirrhosis for autoimmune biliary disease
- •K76.6 — Portal hypertension as complication rather than primary diagnosis
- •K72.90 — Hepatic failure for acute presentations