K76.6

K76.6: Portal hypertension

Billable / specific codeICD-10-CM

K76.6 is a billable, specific ICD-10-CM code for portal hypertension. It is valid for submission on a claim.

Check K76.6 with the rest of the claim: free scrubber

Use additional code

Add a secondary code to capture the detail described below.

code for any associated complications, such as:
portal hypertensive gastropathy (K31.89)

Excludes2 inherited from the categories above K76.6

Not part of this code, but both may be coded when both are present.

Written on K76: Other diseases of liver

alcoholic liver disease (K70.-)
amyloid degeneration of liver (E85.-)
cystic disease of liver (congenital) (Q44.6)
hepatic vein thrombosis (I82.0)
hepatomegaly NOS (R16.0)
pigmentary cirrhosis (of liver) (E83.110)
portal vein thrombosis (I81)
toxic liver disease (K71.-)

Risk adjustment

K76.6 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 63 Chronic Liver Failure/End-Stage Liver Disorders0.962 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

K76.6 is named in 14 Medicare coverage policies: 14 listing it as supporting medical necessity. Which one applies depends on your Medicare contractor.

A56389Billing and Coding: Upper Gastrointestinal Endoscopy and Visualization
A56414Billing and Coding: Endovenous Stenting
A56421Billing and Coding: CT of the Abdomen and Pelvis
A56461Billing and Coding: Endoscopy by Capsule

Alphabetic index entries that lead here

Banti's disease or syndrome(with cirrhosis) (with portal hypertension)
Fibrosis, fibrotic›hepatolienal(portal hypertension)
Fibrosis, fibrotic›hepatosplenic(portal hypertension)
Hypertension, hypertensive›portal(due to chronic liver disease) (idiopathic)
Increase, increased›venous pressure›portal

Code history

Unchanged in every release from FY2024 to FY2027.