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B15 vs K74.1

B15 (Acute hepatitis A) compared with K74.1 (Hepatic sclerosis), from the official CMS tabular data.

Summary

These codes can be reported together when both conditions are documented, because K74.1 lists B15 under Excludes2, which marks them as distinct conditions.

Official rule
What is different?

The conditions named, billing status and chapter.B15 is “Acute hepatitis A”; K74.1 is “Hepatic sclerosis”. B15 is a non-billable header; K74.1 is billable. B15 sits in A00-B99 — Certain Infectious and Parasitic Diseases (A00-B99); K74.1 in K00-K95 — Diseases of the Digestive System (K00-K95).

Registry fact

Can these codes be reported together?

Yes, when both are documented.K74.1 lists B15 under Excludes2: “viral hepatitis (B15-B19)”. Excludes2 marks distinct conditions that may both be reported when both are documented.

Official ruleGuide: Excludes1 vs Excludes2

Is there an Excludes1 relationship?

None.Neither entry carries an Excludes1 note that names the other code. B15 carries 1 Excludes1 note and K74.1 carries 7 Excludes1 notes covering other codes; the side-by-side table quotes them.

Official rule

Is there an Excludes2 relationship?

Yes.K74.1’s tabular entry: “viral hepatitis (B15-B19)”. The note covers B15.

Official ruleGuide: Excludes1 vs Excludes2

Is one more specific?

Not comparable.The codes sit in different categories; specificity is only comparable within one category.

Is one a parent or header code?

One is a header.B15 is a non-billable header, but K74.1 is not one of its subdivisions.

Registry fact

Are there sequencing instructions?

No order is given.The Code Also note linking them states no sequencing order; sequence by the reason for the encounter.

Official ruleGuide: Code First vs Use Additional Code vs Code Also

Are there other coding relationships?

Yes.Both codes may be needed together. K74.1 carries a Code Also note covering B15: “, if applicable, viral hepatitis (acute) (chronic) (B15-B19)”

Official ruleGuide: Code First vs Use Additional Code vs Code Also

Official rule: a tabular instructional note or a section of the ICD-10-CM Official Guidelines, quoted as published. Registry fact: the codes’ own published attributes (titles, billable status, position in the hierarchy, code set). MedCoder-derived: a reading MedCoder computes from those facts; it is not itself a rule. How to read the labels

Can these codes be reported together?

Informational

Code Also relationship

K74.1
Hepatic sclerosis
↔
B15
Acute hepatitis A

What we found

Both codes may be needed together.K74.1 carries a Code Also note covering B15: “, if applicable, viral hepatitis (acute) (chronic) (B15-B19)”

A Code Also note means the two codes may both be required to fully describe the condition. CMS states no sequencing order for it — sequence by the reason for the encounter.

What to review

Report both when both are needed to describe the condition, sequenced by the reason for the encounter.

Guide: Code First vs Use Additional Code vs Code AlsoCheck these on a claim

Why it matters

A "Code Also" note means two codes may be required together, but the Guidelines state no sequencing order for it -- sequence by the reason for the encounter, not by this relationship.

Source / rule

CMS ICD-10-CM tabular instructional notes

Informational

Excludes2 relationship

K74.1
Hepatic sclerosis
↔
B15
Acute hepatitis A

What we found

Yes, when both are documented.K74.1 carries an Excludes2 note covering B15: “viral hepatitis (B15-B19)”

Excludes2 marks distinct conditions — both may be reported when both are documented.

What to review

Report both only when the documentation supports both conditions; otherwise report the one documented.

Guide: Excludes1 vs Excludes2Check these on a claim

Why it matters

An Excludes2 note means the excluded condition is not part of the code above it, but a patient can have both. Report both when both are documented.

Source / rule

CMS ICD-10-CM tabular instructional notes

Official guidance behind these answers

  • Section I.A.12.b — Excludes2 · applies to: Excludes2

    A type 2 Excludes note represents “Not included here.” An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.

    ICD-10-CM Official Guidelines FY2026

  • Section I.A.17 — “Code also ” note · applies to: Code also

    A “code also” note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction. The sequencing depends on the circumstances of the encounter.

    ICD-10-CM Official Guidelines FY2026

Quoted from the ICD-10-CM Official Guidelines for Coding and Reporting in effect for the release shown. The tabular notes above are the code-level instruction; these sections are the convention that says how such a note is applied. Source document (CMS PDF) · Release and checksum

Side by side

B15Acute hepatitis AK74.1Hepatic sclerosis
Billing statusNon-billable header

Report instead: B15.0, B15.9

Billable
ClassificationA00-B99 — Certain Infectious and Parasitic Diseases (A00-B99)K00-K95 — Diseases of the Digestive System (K00-K95)
DefinitionAcute hepatitis A is a non-billable ICD-10-CM category code (B15).Hepatic sclerosis is a billable ICD-10-CM diagnosis code (K74.1).
Excludes1
sequelae of viral hepatitis (B94.2)
alcoholic cirrhosis (of liver) (K70.3)
alcoholic fibrosis of liver (K70.2)
cardiac sclerosis of liver (K76.1)
cirrhosis (of liver) with toxic liver disease (K71.7)
congenital cirrhosis (of liver) (P78.81)
pigmentary cirrhosis (of liver) (E83.110)
jaundice NOS (R17)
Excludes2
cytomegaloviral hepatitis (B25.1)
herpesviral [herpes simplex] hepatitis (B00.81)
hemochromatosis (E83.11-)
Reye's syndrome (G93.7)
viral hepatitis (B15-B19)
Wilson's disease (E83.01)
Code also—
, if applicable, viral hepatitis (acute) (chronic) (B15-B19)

Notes are the code’s own tabular entry, quoted as published. A note that names the other code is the one the verdict above rests on.

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Derived from the official CMS ICD-10-CM tabular data (FY2027). A coding-rule comparison, not billing advice: payer-specific edits and medical-necessity policy are outside its scope. All data sources