K71.7 — Toxic liver disease with fibrosis and cirrhosis of liver
ICD-10-CM
Prior Authorization
No Prior Auth Required
Code is covered without prior authorization (high confidence)
Documentation Required
- This billing and coding article provides guidelines that complement Local Coverage Determination L34415 for CT of the abdomen and pelvis; consult LCD L34415 for specific coverage indications, limitations, and documentation requirements.
- This article provides billing, coding, and guideline information that complements Local Coverage Determination (LCD) L34544; consult LCD L34544 for clinical eligibility, coverage criteria, and required documentation for hospice services for liver disease.
- All documentation must be maintained in the patient’s medical record and made available to the contractor upon request.
- Every page of the record must be legible and include appropriate patient identification information, including complete patient name and dates of service.
Key Coverage Criteria
- Upper gastrointestinal endoscopy (diagnostic or therapeutic) is covered when determined reasonable and necessary per Local Coverage Determination L35350.
- CT abdomen is medically necessary to evaluate abdominal pain.
- CT abdomen is medically necessary to evaluate known or suspected abdominal masses or fluid collections.
- CT abdomen is medically necessary for evaluation of primary or metastatic malignancies in the abdomen.
- CT abdomen is medically necessary to evaluate abdominal inflammatory processes.
- CT abdomen is medically necessary to evaluate abnormalities of abdominal vascular structures.
8 Active Policies
L35350 — Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
J12
A57414 — Billing and Coding: Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)
J12
A56421 — Billing and Coding: CT of the Abdomen and Pelvis
A56669 — Billing and Coding: Hospice - Liver Disease
L34544 — Hospice - Liver Disease
Related Codes
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