K74.3 — Primary biliary cirrhosis
K74.3 is a billable, specific ICD-10-CM code for primary biliary cirrhosis. It is valid for submission on a claim.
Excludes2 — not included here, but may coexist
The excluded condition is not part of this code, but a patient can have both. You may code both.
- primary sclerosing cholangitis (K83.01)
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Chronic nonsuppurative destructive cholangitis
- Primary biliary cholangitis
Risk adjustment
K74.3 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:
- HCC 68 Cholangitis and Obstruction of Bile Duct Without Gallstones0.388 RAF
Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.
Medicare coverage
K74.3 is named in 18 Medicare coverage policies — 18 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56461Billing and Coding: Endoscopy by Capsule
- A56461Billing and Coding: Endoscopy by Capsule
How K74.3 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to K74.3.
- Hanot's cirrhosis or disease
- Charcot's›cirrhosis
- Cholangitis›chronic nonsuppurative destructive
- Cirrhosis, cirrhotic›Charcot's
- Cirrhosis, cirrhotic›cholangiolitic, cholangitic, cholostatic(primary)
- Cirrhosis, cirrhotic›Hanot's(hypertrophic)
- Cirrhosis, cirrhotic›hypertrophic
- Cirrhosis, cirrhotic›monolobular
- Cirrhosis, cirrhotic›Todd's
- Cirrhosis, cirrhotic›unilobar
- Todd's›cirrhosis
- Cirrhosis, cirrhotic›biliary›primary
Related codes at this level
Codes that share K74. If K74.3 is not quite right, the correct code is usually one of these.
Questions about K74.3
- Is K74.3 a billable ICD-10-CM code?
- Yes. K74.3 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does K74.3 sit in the tabular list?
- Diseases of the digestive system (K00-K95), in the block Diseases of liver (K70-K77).