Coding, Classification & Reimbursement

Subject: Coding dependence in alcoholic cirrhosis

1.  Coding dependence in alcoholic cirrhosis

Posted 9 days ago
I code for risk adjustment and we are debating picking up the F10.20 code when coding alcoholic cirrhosis.  There is an argument citing an old Coding Clinic from 2nd Quarter, 2002 (Cirrhosis with Gastric Varices) that instructs us to code alcohol dependence when coding alcoholic cirrhosis.  However I do not believe that this is relevant in ICD-10 as we now have an Instructional Note that was not included in ICD-9.  In ICD-10, we are directed to "Use additional code" to identify alcohol abuse and dependence, F10 – F10.99; this range includes alcohol use, abuse and dependence.  This would lead me to believe that the 2002 Coding Clinic with regard to coding alcohol dependence is no longer valid.  The term "alcoholic" in alcoholic cirrhosis appears only to reflect the etiology of the liver disease and not the alcohol status of the patient.  I would love to hear other views on this.  Thank you.

Patricia Canary, CRC, CCS
Coding Quality Analyst
Optum 360