K70.40 ICD-10-CM Code: Alcoholic hepatic failure without coma

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K70.40 in the official ICD-10-CM tabular list, quoted as published.

Source: CMS/CDC — ICD-10-CM Tabular ListRelease: FY2026Effective: October 1, 2025

Notes without a marker are published on K70.40 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for K70.40

MedCoder structured workflow — derived from this code’s own official record

Before you code K70.40

1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with K70.40. Excludes1 conditions are not reported together with this code unless the record shows they are unrelated (Guidelines I.A.12.a).

   See the official tabular notes

Choose the right path

1. Does the documentation support a condition named in K70.40’s Excludes1 note?
   Yes → Do not simply proceed: review the excluded code. Both are reported only when the record shows the two conditions are unrelated.
   No → Continue.

   ReviewR17

Consider K70.40. Then work the Use Additional Code note, and confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

The associated condition or complication

Whether the associated condition the title names is documented; the “with” convention presumes some links, and a provider statement that the conditions are unrelated defeats it (Guidelines I.A.15).

The conditions the Use Additional Code note names

Reported with this code when documented; a conditional instruction (“if applicable”, “if known”) applies only when the record supports it.

Official instructions as workflow

• Excludes1 — check before selecting K70.40(1 note)

  Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with K70.40: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

  CompareR17

  See the official tabular notes · Guidelines I.A.12.a

• Excludes2 — not part of K70.40(4 notes)

  Coding workflow: The conditions named in this note are not included in K70.40. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareE83.11, G93.7, E83.01

  See the official tabular notes · Guidelines I.A.12.b

• Use Additional Code — after identifying K70.40(2 notes)

  Coding workflow: Check whether the documentation supports the additional code(s) the note names, and report them with K70.40 when it does. Where the instruction is conditional (“if applicable”, “if known”), it applies only when the record documents the condition.

  ReviewF10

  See the official tabular notes · Guidelines I.A.13

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Indexed Clinical Terms (2)

Official source data — entries quoted as published, in the Index’s own lookup phrasing

Clinical term phrases from the official ICD-10-CM Index to Diseases and Injuries that map to this code. These are alphabetic-index entries shown as the Index writes them — lookup phrasing, not necessarily the wording of a final diagnosis.

• Disease, diseased, liver (chronic) (organic), alcoholic (chronic), failure
• Failure, failed, hepatic, alcoholic (acute) (chronic) (subacute)

Official Coding Guidelines

No excerpt in the ICD-10-CM Official Guidelines names this code specifically. Its chapter carries only this chapter-wide note:

Don’t confuse K70.40 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of K70.40 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• R17— Excludes1 conflict (Excludes1 — generally not reported together)

  Not coded here — the tabular list excludes this pair for the same encounter.

  Not reported together with this code, except where the two conditions are documented as unrelated.

  What moves you there: Documentation of jaundice NOS moves the case to R17; the two are not reported together unless documented as unrelated.

  Full comparison: K70.40 vs R17 →

• E83.11— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of hemochromatosis adds E83.11; it is not part of this code and both may be reported when both are documented.

  Full comparison: K70.40 vs E83.11 →

• G93.7— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of Reye's syndrome adds G93.7; it is not part of this code and both may be reported when both are documented.

  Full comparison: K70.40 vs G93.7 →

• B15— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of viral hepatitis adds B15; it is not part of this code and both may be reported when both are documented.

  Full comparison: K70.40 vs B15 →

• B19— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of viral hepatitis adds B19; it is not part of this code and both may be reported when both are documented.

  Full comparison: K70.40 vs B19 →

• E83.01— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of Wilson's disease adds E83.01; it is not part of this code and both may be reported when both are documented.

  Full comparison: K70.40 vs E83.01 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Decision Points

The directives on this code's own record, as a pre-claim checklist.

1. 2 Use Additional Code instructions — report the named additional code(s) when the documentation supports them. See the Use Additional Code notes
2. 1 Excludes1 entry — codes named there are generally not reported together with this code (Guidelines I.A.12.a). See the Excludes1 notes
3. 4 Excludes2 entries — those conditions are not part of this code and may be reported additionally when documented. See the Excludes2 notes

Checklist rows are derived from this code's own official directives; the wording of each check is MedCoder editorial. The official notes themselves are in the sections each row links to.

Verify Before Coding

• Age-restricted: the Medicare Code Editor lists this as an adult (age 15-124) diagnosis; other ages are presumed incorrect.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name K70.40 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 1 Excludes1 note: K77 — Liver disorders in diseases classified elsewhere (via K70.-).

These codes’ tabular lists mark this diagnosis as mutually exclusive — not reported together unless the conditions are documented as unrelated.

Referenced by 2 Excludes2 notes: K71 — Toxic liver disease (via K70.-), K76 — Other diseases of liver (via K70.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Referenced by 1 Code Also instruction: K76.82 — Hepatic encephalopathy.

These codes suggest coding this condition alongside when both are present.

MS-DRG Grouper Relationships (FY2026)

Potential MS-DRG participation — not a DRG assignment.

FY2026 MS-DRG: not on the CMS CC/MCC list — as a secondary diagnosis this code does not change MS-DRG severity for that release.

Named in the grouper logic of 3 MS-DRGs: DRG 432 (MDC 07), DRG 433 (MDC 07), DRG 434 (MDC 07).

From the CMS MS-DRG Definitions Manual (Appendices B and C). Actual DRG assignment depends on the complete claim.

Clinical classification (AHRQ CCSR):DIG018 — Hepatic failure (default); MBD017 — Alcohol-related disorders.

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same CMS-HCC risk category (V28)

CMS maps these diagnoses to the same Hierarchical Condition Category (Chronic Liver Failure/End-Stage Liver Disorders) for risk-adjusted payment.

I85.00 — Esophageal varices without bleeding, I85.01 — Esophageal varices with bleeding, I85.10 — Secondary esophageal varices without bleeding, I85.11 — Secondary esophageal varices with bleeding, K70.41 — Alcoholic hepatic failure with coma, K72.10 — Chronic hepatic failure without coma, K72.11 — Chronic hepatic failure with coma, K72.90 — Hepatic failure, unspecified without coma, K72.91 — Hepatic failure, unspecified with coma, K76.6 — Portal hypertension, K76.7 — Hepatorenal syndrome, K76.81 — Hepatopulmonary syndrome, K76.82 — Hepatic encephalopathy

Related risk categories

These categories interact through CMS's HCC hierarchy — one can suppress the other's risk-adjustment weight when both are present on a claim.

Liver Transplant Status/Complications, Coma, Brain Compression/Anoxic Damage, Cirrhosis of Liver, Chronic Hepatitis, Cholangitis and Obstruction of Bile Duct Without Gallstones

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical categories (Hepatic failure, Alcohol-related disorders).

G62.1 — Alcoholic polyneuropathy, I42.6 — Alcoholic cardiomyopathy, K29.20 — Alcoholic gastritis without bleeding, K29.21 — Alcoholic gastritis with bleeding, K70.0 — Alcoholic fatty liver, K70.10 — Alcoholic hepatitis without ascites, K70.11 — Alcoholic hepatitis with ascites, K70.2 — Alcoholic fibrosis and sclerosis of liver, K70.30 — Alcoholic cirrhosis of liver without ascites, K70.31 — Alcoholic cirrhosis of liver with ascites, K70.41 — Alcoholic hepatic failure with coma, K70.9 — Alcoholic liver disease, unspecified, K72.00 — Acute and subacute hepatic failure without coma, K72.01 — Acute and subacute hepatic failure with coma, K72.10 — Chronic hepatic failure without coma, K72.11 — Chronic hepatic failure with coma, K72.90 — Hepatic failure, unspecified without coma, K72.91 — Hepatic failure, unspecified with coma, K91.82 — Postprocedural hepatic failure, O35.4XX0 — Maternal care for (suspected) damage to fetus from alcohol, not applicable or unspecified, +68 more

Same Index main term, other category

The ICD-10-CM Index to Diseases and Injuries files this code under the main term “Failure, failed”; these codes share that main term but sit in a different category of the Tabular List.

J96.02 — Acute respiratory failure with hypercapnia (respiration, respiratory, acute, with, hypercarbia), J96.10 — Chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (respiration, respiratory, chronic), J96.11 — Chronic respiratory failure with hypoxia (respiration, respiratory, chronic, with, hypoxia), J96.12 — Chronic respiratory failure with hypercapnia (respiration, respiratory, chronic, with, hypercapnia), J96.20 — Acute and chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (respiration, respiratory, acute andchronic), J96.21 — Acute and chronic respiratory failure with hypoxia (respiration, respiratory, acute andchronic, with, hypoxia), J96.22 — Acute and chronic respiratory failure with hypercapnia (respiration, respiratory, acute andchronic, with, hypercapnia), J96.90 — Respiratory failure, unspecified, unspecified whether with hypoxia or hypercapnia (respiration, respiratory), J96.91 — Respiratory failure, unspecified with hypoxia (respiration, respiratory, with, hypoxia), J96.92 — Respiratory failure, unspecified with hypercapnia (respiration, respiratory, with, hypercarbia), K71.10 — Toxic liver disease with hepatic necrosis, without coma (hepatic, due to drugs), K71.11 — Toxic liver disease with hepatic necrosis, with coma (hepatic, due to drugs, with coma), K72.00 — Acute and subacute hepatic failure without coma (hepatic, acute or subacute), K72.01 — Acute and subacute hepatic failure with coma (hepatic, acute or subacute, with coma), K72.10 — Chronic hepatic failure without coma (hepatic, chronic), K72.11 — Chronic hepatic failure with coma (hepatic, chronic, with coma), K72.90 — Hepatic failure, unspecified without coma (hepatic), K72.91 — Hepatic failure, unspecified with coma (hepatic, with coma), K76.7 — Hepatorenal syndrome (hepatorenal), K90.83 — Intestinal failure (intestinal), +129 more

Lab tests where this diagnosis supports Medicare coverage (NCD)

Medicare's National Coverage Determination (NCD) program lists this diagnosis as medical justification for these lab tests.

Fecal Occult Blood Test (FOBT), Gamma-glutamyl Transferase (GGT) Test, Iron Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of K70.40 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run K70.40 with these 4 related codes in Claim Check

Hierarchy

• K00-K95 — Chapter 11: Diseases of the Digestive System (K00-K95) (K00-K95)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70-K77 — Diseases of liver[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes1 notes

• K77 — Liver disorders in diseases classified elsewhere[Excludes1](via K70.-): “alcoholic liver disease (K70.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Excludes2 notes

• K71 — Toxic liver disease[Excludes2](via K70.-): “alcoholic liver disease (K70.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• K76 — Other diseases of liver[Excludes2](via K70.-): “alcoholic liver disease (K70.-)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Referenced by Code Also instructions

• K76.82 — Hepatic encephalopathy[Code Also]: “alcoholic hepatic failure without coma (K70.40)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• DIG018 — Hepatic failure[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)
• MBD017 — Alcohol-related disorders[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Risk adjustment (CMS-HCC)

• HCC 63 — Chronic Liver Failure/End-Stage Liver Disorders [CMS-HCC]: “Chronic Liver Failure/End-Stage Liver Disorders — supersedes HCC 64 (Cirrhosis of Liver), HCC 65 (Chronic Hepatitis), HCC 68 (Cholangitis and Obstruction of Bile Duct Without Gallstones), HCC 202 (Coma, Brain Compression/Anoxic Damage)”— CMS-HCC V28 · 2026

MS-DRG Grouper

• DRG 432 — CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC[MS-DRG]: “CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC (MDC 07)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 433 — CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC[MS-DRG]: “CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC (MDC 07)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026
• DRG 434 — CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC[MS-DRG]: “CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC (MDC 07)”— CMS MS-DRG Definitions Manual (Appendix B) · FY2026

MDC crossing

• MDC 07 — Diseases and Disorders of the Hepatobiliary System and Pancreas[MDC crossing]: “Diseases and Disorders of the Hepatobiliary System and Pancreas — the grouper's crossing between diagnoses and procedures: a principal diagnosis sets the MDC, and same-MDC procedures move the stay to its surgical DRGs. 2,481 same-MDC procedures group here; browse them on the MDC page.”— CMS MS-DRG Definitions Manual · FY2026

Index entries

• Disease, diseased, liver (chronic) (organic), alcoholic (chronic), failure[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
• Failure, failed, hepatic, alcoholic (acute) (chronic) (subacute)[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (12)

• K70 — Alcoholic liver disease[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.0 — Alcoholic fatty liver[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.1 — Alcoholic hepatitis[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.10 — Alcoholic hepatitis without ascites[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.11 — Alcoholic hepatitis with ascites[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.2 — Alcoholic fibrosis and sclerosis of liver[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.3 — Alcoholic cirrhosis of liver[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• K70.30 — Alcoholic cirrhosis of liver without ascites[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• and 4 more

Change history

• FY2016 — In the code set at ICD-10-CM adoption [Change history]— CMS release files (code change ledger) · icd10cm-fy2016

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Coding guidelines Official source data

ICD-10-CM Official Guidelines for Coding and Reporting (FY2026), quoted by section Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Inpatient payment groups Official source data

CMS MS-DRG Definitions Manual (incl. Appendix B diagnosis index, Appendix C CC/MCC list, Appendix E procedure index) and IPPS Final Rule tables — v43 Release, file and checksum · Publisher’s page

Risk adjustment Official source data

2026 Mid-Year Final ICD-10 Mappings + Model Software (cms.gov/files/zip/2026-midyear-final-icd-10-mappings.zip, 2026-midyear-final-model-software.zip) — CMS-HCC V28, PY2026 mid-year final release Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K70.40 in its code family, with their registry titles.

• K70.1 — Alcoholic hepatitis
• K70.10 — Alcoholic hepatitis without ascites
• K70.11 — Alcoholic hepatitis with ascites
• K70.2 — Alcoholic fibrosis and sclerosis of liver
• K70.3 — Alcoholic cirrhosis of liver
• K70.30 — Alcoholic cirrhosis of liver without ascites
• K70.31 — Alcoholic cirrhosis of liver with ascites
• K70.4 — Alcoholic hepatic failure
• K70.41 — Alcoholic hepatic failure with coma
• K70.9 — Alcoholic liver disease, unspecified

View all codes in the K70 family