K76.82

Billable

Hepatic encephalopathy

HCC Category Mapping

V28HCC 63 — End-Stage Liver Disease

0.307

V24HCC 27 — End-Stage Liver Disease

0.910

ESRDHCC 27 — End-Stage Liver Disease

0.000

What This Code Means

Brain dysfunction caused by liver failure, where the liver cannot remove toxic substances from the blood, leading to confusion and altered consciousness.

Coding Tips

•Specify the grade of encephalopathy if documented (minimal, grade 1-4)
•Always code the underlying liver disease as the primary condition

Clinical Significance

Hepatic encephalopathy represents brain dysfunction due to liver failure's inability to clear toxic metabolites, particularly ammonia. This serious complication indicates advanced liver disease and requires immediate treatment to prevent progression to coma.

Documentation Requirements

✓Clinical evidence of altered mental status or cognitive impairment
✓Underlying liver disease or portosystemic shunting
✓Elevated serum ammonia levels (when available)
✓Exclusion of other causes of encephalopathy
✓Grading of encephalopathy severity (Grade 1-4)
✓Precipitating factors documentation (infection, GI bleeding, medications)
✓Clinical features like asterixis, confusion, or personality changes
✓Response to treatments like lactulose or rifaximin

Excludes 1 — Do NOT code together

acute and subacute hepatic failure with coma (K72.01)
alcoholic hepatic failure with coma (K70.41)
chronic hepatic failure with coma (K72.11)
hepatic failure with coma (K72.91)

Code Also

underlying liver disease, such as:
acute and subacute hepatic failure without coma (K72.00)
alcoholic hepatic failure without coma (K70.40)
chronic hepatic failure without coma (K72.10)
hepatic failure with toxic liver disease without coma (K71.10)
hepatic failure without coma (K72.90)
icterus of newborn (P55-P59)
postprocedural hepatic failure (K91.82)
viral hepatitis without hepatic coma (B15.9, B16.1, B16.9, B17.10, B19.10, B19.20, B19.9)

Commonly Confused Codes

F05 — Delirium due to other medical conditions without liver disease G93.1 — Anoxic brain damage when hypoxia is the cause E87.2 — Acidosis when metabolic disturbance is primary K72.90 — Hepatic failure may coexist but encephalopathy is the neurologic manifestation F10.231 — Alcohol withdrawal delirium when alcohol is the cause

Code Hierarchy

└K76Other diseases of liver └K76.8Other specified diseases of liver └K76.82Hepatic encephalopathy

└K76.82Hepatic encephalopathy