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K74.1 ICD-10-CM Code: Hepatic sclerosis

Billing Status: YES. This is a valid, specific, and billable ICD-10-CM reference.

Coding at a Glance

Tabular directives
7 Excludes1 · 4 Excludes2 · 1 code-also instruction

Inpatient Payment Groups (MS-DRG)

Potential MS-DRG participation — not a DRG assignment.

MS-DRGs this diagnosis helps define, as principal or secondary, per the CMS ICD-10-CM/PCS MS-DRG Definitions Manual v43, Appendix B.

  • MS-DRG 441 — DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC (MDC 07)
  • MS-DRG 442 — DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC (MDC 07)
  • MS-DRG 443 — DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC (MDC 07)

A diagnosis appearing in a group's logic does not by itself determine the DRG assigned to a stay; the grouper uses the full claim.

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for K74.1 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 K74.1 itself; “inherited from” names the category or block whose note applies here.

Excludes1 — Not Coded Here

Conditions generally not reported together with this code (Excludes1) -- an error unless the two conditions are documented as unrelated to each other (ICD-10-CM Official Guidelines, Section I.A.12.a).

Excludes2 — Not Included Here

Conditions not covered by this code, but which may be reported alongside it when both are present.

Source: inherited from K70-K77

Code Also

Additional codes that may be required to fully describe the encounter.

  • Code also, if applicable, viral hepatitis (acute) (chronic) (B15-B19)

Source: inherited from K74

Coder workflow for K74.1

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

Before you code K74.1

  1. Check the Excludes1 note: if the documentation supports a condition named there, do not simply proceed with K74.1. 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 K74.1’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.

    ReviewK70.3, K70.2, K76.1, K71.7, P78.81, E83.110

Consider K74.1. Then review the Code Also 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).

Official instructions as workflow

  • Excludes1 — check before selecting K74.1(7 notes)

    Coding workflow: If the documentation supports a condition named in this note, do not simply proceed with K74.1: the two are not reported together. The one exception is when the record shows the two conditions are unrelated to each other.

    CompareK70.3, K70.2, K76.1, K71.7, P78.81, E83.110

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

  • Excludes2 — not part of K74.1(4 notes)

    Coding workflow: The conditions named in this note are not included in K74.1. 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

  • Code Also — related condition(1 note)

    Coding workflow: Review the related condition when both are documented and the instruction applies. A Code Also note does not fix sequencing; the order follows the circumstances of the encounter.

    See the official tabular notes · Guidelines I.A.17

Coding decision scenarios

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

Documentation: Both the condition K74.1 describes and a condition named in its Excludes1 note are documented for the same encounter.

Coding question: Can both codes be reported?

Path: Review the Excludes1 note and the excluded code, and look for a provider statement on whether the two conditions are related.

Reason: Excludes1 means the two are not coded together; the exception is when the record shows the conditions are unrelated to each other (Guidelines I.A.12.a).

ReviewK70.3, K70.2, K76.1, K71.7, P78.81, E83.110

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.

Code Overview

Hepatic sclerosis is a billable ICD-10-CM diagnosis code (K74.1).

MedCoder summary Summary composed by MedCoder from this code's official ICD-10-CM record. The tabular instructional notes themselves appear verbatim below.

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.

Official Coding Guidelines

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

Chapter 11: Diseases of the Digestive System (K00-K95)

Reserved for future guideline expansion

Decision Points

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

  1. 1 Code Also note — a second code may apply; the guidelines leave its sequencing to the circumstances of the encounter. See the Code Also notes
  2. 7 Excludes1 entries — 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

  • No Medicare Code Editor or MS-DRG Definitions Manual restrictions apply to this code.

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

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 441 (MDC 07), DRG 442 (MDC 07), DRG 443 (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):DIG019 — Other specified and unspecified liver disease (default).

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 clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Other specified and unspecified liver disease).

K71.0 — Toxic liver disease with cholestasis, K71.10 — Toxic liver disease with hepatic necrosis, without coma, K71.11 — Toxic liver disease with hepatic necrosis, with coma, K71.7 — Toxic liver disease with fibrosis and cirrhosis of liver, K71.8 — Toxic liver disease with other disorders of liver, K71.9 — Toxic liver disease, unspecified, K74.0 — Hepatic fibrosis, K74.00 — Hepatic fibrosis, unspecified, K74.01 — Hepatic fibrosis, early fibrosis, K74.02 — Hepatic fibrosis, advanced fibrosis, K74.2 — Hepatic fibrosis with hepatic sclerosis, K74.3 — Primary biliary cirrhosis, K74.4 — Secondary biliary cirrhosis, K74.5 — Biliary cirrhosis, unspecified, K74.60 — Unspecified cirrhosis of liver, K74.69 — Other cirrhosis of liver, K75.1 — Phlebitis of portal vein, K75.89 — Other specified inflammatory liver diseases, K75.9 — Inflammatory liver disease, unspecified, K76.0 — Fatty (change of) liver, not elsewhere classified, +33 more

Same Index main term, other category

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

I27.0 — Primary pulmonary hypertension (pulmonary, artery), I42.4 — Endocardial fibroelastosis (subendocardial, congenital), I44.39 — Other atrioventricular block (bundle of His), I67.2 — Cerebral atherosclerosis (brain, senile), I70.0 — Atherosclerosis of aorta (aorta, aortic), I87.8 — Other specified disorders of veins (vein), I89.8 — Other specified noninfective disorders of lymphatic vessels and lymph nodes (gland), J38.7 — Other diseases of larynx (larynx), K31.89 — Other diseases of stomach and duodenum (stomach), K70.2 — Alcoholic fibrosis and sclerosis of liver (liver, alcoholic), K76.1 — Chronic passive congestion of liver (liver, cardiac), K86.89 — Other specified diseases of pancreas (pancreas), M34.0 — Progressive systemic sclerosis (progressive, systemic), M34.2 — Systemic sclerosis induced by drug and chemical (systemic, drug-induced), M34.81 — Systemic sclerosis with lung involvement (systemic, with, lung involvement), M34.82 — Systemic sclerosis with myopathy (systemic, with, myopathy), M34.83 — Systemic sclerosis with polyneuropathy (systemic, with, polyneuropathy), M34.89 — Other systemic sclerosis (systemic, specified NEC), M34.9 — Systemic sclerosis, unspecified (systemic), N05.1 — Unspecified nephritic syndrome with focal and segmental glomerular lesions (focal and segmental), +35 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, Lipid Panel, Partial Thromboplastin Time (PTT) Test, Prothrombin Time Test and INR (PT/INR)

Contextual Map

Every relationship of K74.1 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.

Hierarchy

Clinical classification (CCSR)

MS-DRG Grouper

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

  • Sclerosis, sclerotic, hepatic[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026
  • Sclerosis, sclerotic, liver[Index term]— CMS ICD-10-CM Index to Diseases and Injuries · icd10cm-fy2026

Nearest codes (13)

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
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

Cite this page

Reference this page in a research guide, syllabus or article. The release is included because code content changes each year.

MedCoder.ai. "K74.1 — Hepatic sclerosis." ICD-10-CM FY2026. https://medcoder.ai/icd10/code/k74.1-hepatic-sclerosis

Change history

  • FY2016 — October 1, 2015
    In the code set at ICD-10-CM adoption
    Hepatic sclerosis

No changes since FY2016 — additions, deletions, description changes and billable-status changes are tracked through FY2027 (effective October 1, 2026), and none are recorded for this code. Note changes are tracked from FY2027 only.

Nearest Codes in This Family

Official ICD-10-CM classifications closest to K74.1 in its code family, with their registry titles.

View all codes in the K74 family