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.
Check K74.3 with the rest of the claim: free scrubberExcludes2: 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
Excludes1 inherited from the categories above K74.3
A category’s note binds every code beneath it.
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. Look up the whole chart to see which of its HCCs the hierarchy would zero.
Medicare coverage
K74.3 is named in 17 Medicare coverage policies: 17 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.
- A56416Billing and Coding: Assays for Vitamins and Metabolic Function
- A56421Billing and Coding: CT of the Abdomen and Pelvis
- A56461Billing and Coding: Endoscopy by Capsule
- A56669Billing and Coding: Hospice - Liver Disease
Alphabetic index entries that lead here
- 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
Code history
Unchanged in every release from FY2024 to FY2027.