K76.7
BillableHepatorenal syndrome
HCC Category Mapping
V28HCC 63 — End-Stage Liver Disease
0.307V24HCC 27 — End-Stage Liver Disease
0.910ESRDHCC 27 — End-Stage Liver Disease
0.000What This Code Means
A serious condition where severe liver disease causes kidney failure, typically occurring in patients with advanced liver cirrhosis.
Coding Tips
- •Always code the underlying liver disease first, then this syndrome as a complication
- •Document the stage of kidney dysfunction and any dialysis requirements
Clinical Significance
Hepatorenal syndrome represents functional kidney failure in patients with advanced liver disease, carrying extremely high mortality risk. This diagnosis indicates end-stage liver disease with multi-organ involvement requiring immediate intensive care and consideration for liver transplantation.
Documentation Requirements
- ✓Advanced liver disease with portal hypertension
- ✓Acute kidney injury with creatinine >1.5 mg/dL
- ✓Absence of shock, bacterial infection, or nephrotoxic drugs
- ✓No improvement with volume expansion
- ✓Oliguria with concentrated urine (usually)
- ✓Exclusion of intrinsic kidney disease
- ✓Clinical criteria meeting international consensus definition
- ✓Documentation of precipitating factors if present
Excludes 1 — Do NOT code together
Commonly Confused Codes
N17.9 — Acute kidney failure unspecified without liver diseaseK76.6 — Portal hypertension may be present but HRS is the acute complicationK72.90 — Hepatic failure may coexist but HRS is the renal complicationN18.6 — Chronic kidney disease when renal failure is not functionalR50.9 — Fever may be present but HRS is the primary diagnosis