K76.82
Hepatic encephalopathy
Clinical Classification Guidelines
Inclusion Terms
- Hepatic encephalopathy, NOS
- Hepatic encephalopathy without coma
- Hepatocerebral intoxication
- Portal-systemic encephalopathy
Excludes Type 1
- 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)
Medical Intelligence & Overview
Hepatic encephalopathy is a complex condition that affects the brain because of liver dysfunction. When the liver is not working properly, substances that are normally removed from the blood can accumulate and cause changes in brain function. This condition, also known as hepatocerebral intoxication or portal-systemic encephalopathy, can vary in severity and may occur with or without loss of consciousness.
Causes & Symptoms
Clinical Causes: Liver cirrhosis due to chronic liver diseases such as hepatitis B or C Acute liver failure from drug overdose or toxins Heavy alcohol consumption damaging liver function Obstruction of bile flow or other liver conditions Infections or gastrointestinal bleeding increasing toxins in the blood Use of certain medications that affect liver metabolism Electrolyte imbalances or dehydration
Key Symptoms: Confusion or forgetfulness Changes in personality or behavior Sleep disturbances, such as drowsiness or insomnia Asterixis (flapping tremor of the hands) Slurred speech Dizziness or coordination problems In severe cases, coma may develop Elevated levels of ammonia in the blood, often detected through blood tests
Diagnostic & Treatment
Diagnosis Path: Diagnosis involves a combination of clinical evaluation and laboratory tests. Doctors typically review symptoms and medical history, conduct a physical exam, and order blood tests to measure ammonia levels and assess liver function. Imaging studies, such as ultrasound or MRI, may be utilized to evaluate liver health and rule out other conditions. The healthcare provider also considers the absence of other potential causes for neurological symptoms.
Treatment Protocols: Treatment aims to manage symptoms and address the underlying liver issues. Common approaches include: - Reducing the production and absorption of toxins in the gut through medications like lactulose - Antibiotics such as rifaximin to decrease intestinal bacteria that produce toxins - Correcting electrolyte imbalances - Managing contributing factors like infections or gastrointestinal bleeding - Abstinence from alcohol and adopting a liver-friendly diet - In severe cases, hospitalization and supportive care, which may involve monitoring and managing neurological status - In some instances, liver transplantation may be considered for advanced liver failure
Clinical Advice & FAQs
Billing Guidance
Is K76.82 a billable ICD-10 code?
Yes, K76.82 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report K76.82?
Clinical documentation must specify the nature of Hepatic encephalopathy and any associated comorbidities for accurate reporting.
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