ICD-10 Code for Fatty (change of) liver, not elsewhere classified

Fatty liver is a common hepatic condition characterized by excess triglyceride accumulation in hepatocytes. Precise ICD-10 coding for fatty liver is essential because it affects clinical registries, quality reporting, payer medical necessity determinations, and reimbursement. Incomplete or inaccurate coding can lead to claim denials, incorrect risk adjustment, and compliance exposure.

This guide explains the ICD-10 code for fatty liver, clinical definitions, clear scenarios for correct code selection, exclusions and alternatives, a concise related-codes table, billing best practices, and audit-focused documentation tips. It is written for coders, billers, and revenue cycle managers who need actionable steps to improve coding accuracy and reimbursement outcomes.

What Is the ICD-10 Code for Fatty (change of) liver, not elsewhere classified?

The ICD-10-CM Code for Fatty (change of) liver, not elsewhere classified is K76.0.

Fatty (change of) liver, not elsewhere classified is a diagnostic term used when hepatic steatosis is identified but no specific etiology is documented or attributable diagnoses (such as alcoholic fatty liver or nonalcoholic steatohepatitis) are not documented. Medically, the condition reflects macrovesicular or microvesicular fat accumulation within hepatocytes demonstrated by imaging or histology, without specifying causation or associated inflammatory changes. In ICD-10-CM classification, K76.0 is a nonspecific code capturing fatty infiltration of the liver that is not otherwise specified under more specific liver disease codes.

When to Use K76.0 Code

Imaging-detected hepatic steatosis without documented etiology

Use K76.0 when abdominal ultrasound, CT, or MRI reports hepatic steatosis or fatty change and clinical documentation does not state a cause such as alcohol-related disease or NASH. The imaging finding alone with no linked diagnosis warrants K76.0 as the principal or secondary diagnosis.

Initial outpatient diagnosis when clinician documents "fatty liver" only

When a clinician documents "fatty liver" or "fatty change of liver" in the problem list or visit note without further specification, assign K76.0. This applies to new diagnoses established in primary care, hepatology evaluation notes that remain nonspecific, and consults where etiology is deferred.

Coding for symptom-driven, low-complexity encounters tied to hepatic steatosis

For brief visits addressing symptoms attributable to fatty liver (e.g., mild right upper quadrant discomfort) where the clinician documents fatty liver as the reason for visit but no additional liver-specific diagnoses are given, K76.0 is appropriate to represent the underlying condition driving the encounter.

When Not to Use K76.0 Code

When a specific cause such as alcohol is explicitly documented

Do not use K76.0 if the record documents alcoholic fatty liver or alcohol-related steatosis. Use the alcohol-specific code Alcoholic fatty liver (K70.0) or other appropriate alcohol-related liver disease codes to reflect etiology and support clinical necessity for interventions tied to alcohol use.

When nonalcoholic steatohepatitis (NASH) or inflammatory change is diagnosed

If the clinician documents NASH, steatohepatitis, or histologic inflammation in addition to steatosis, K76.0 is not appropriate. Use Nonalcoholic steatohepatitis (K75.81) when NASH is specified, since inflammatory changes carry different prognosis and management.

When advanced fibrosis or cirrhosis is present or documented

If the chart documents cirrhosis or fibrosis attributable to steatosis, K76.0 should not be used alone. Select codes reflecting cirrhosis (for example, K74.60 for unspecified cirrhosis) or other specific fibrosis codes; include fatty liver as a contributing condition only when clinically relevant and documented.

Related ICD-10 Codes for fatty liver

Condition	Code	When It Is Used	When It Is Not Used
Fatty (change of) liver, not elsewhere classified	K76.0	Use when imaging or clinician documents hepatic steatosis/fatty change and no specific cause (alcoholic, NASH) or complications are specified.	Do not use when etiology is documented (e.g., alcoholic fatty liver, NASH) or when cirrhosis/fibrosis is documented as primary diagnosis.
Alcoholic fatty liver	K70.0	Use when clinician documents fatty liver attributable to alcohol use or when alcohol-related etiology is clearly established in history and assessment.	Do not use for nonalcoholic steatosis or when documentation lacks evidence linking alcohol to liver changes.
Nonalcoholic steatohepatitis (NASH)	K75.81	Use when clinician documents steatohepatitis or biopsy/imaging notes inflammatory changes consistent with NASH; appropriate when metabolic risk factors are present and NASH is diagnosis.	Do not use when only steatosis is documented without inflammatory change or when etiology is alcoholic.
Unspecified cirrhosis of liver	K74.60	Use when chart documents cirrhosis without specification of cause; assign when cirrhosis is the primary liver pathology regardless of steatosis mention.	Do not use when only hepatic steatosis is documented without evidence of cirrhosis or when a specific cause of cirrhosis is documented and coded accordingly.

Best Practices for Getting Reimbursed When Using Fatty (change of) liver, not elsewhere classified ICD-10 Codes

Document etiology and risk factors explicitly

Always capture alcohol use, metabolic syndrome components (diabetes, obesity, hyperlipidemia), and medication history. Clear linkage between risk factors and fatty liver supports medical necessity and appropriate code selection.

Differentiate steatosis from steatohepatitis and cirrhosis

Include assessment statements that distinguish simple fatty infiltration from NASH and cirrhosis. When biopsy, elastography, or imaging identifies inflammation or fibrosis, document these findings and assign more specific liver codes in addition to or instead of K76.0.

Use problem lists and visit assessment fields for clarity

Ensure the problem list and visit assessment reflect the same terminology used by the clinician. If "fatty liver" is intended as chronic or active problem, document status (active vs. resolved) and acuity to justify encounter-level coding and resource utilization.

Capture linked signs, symptoms, and testing to demonstrate medical necessity

Document abnormal liver enzymes, ordered liver imaging, referrals (hepatology, nutrition), or counseling provided. These linked elements strengthen claims that services were medically necessary for management of fatty liver.

Implement coder-provider query workflows for ambiguity

When documentation is vague (e.g., "fatty changes" with no etiology), use a concise query to ask the provider to clarify etiology, chronicity, and presence of inflammation or fibrosis. Well-constructed queries reduce denial risk and support accurate risk adjustment.

Billing and Reimbursement Considerations

Coding for fatty liver has direct impact on revenue cycle outcomes:

Reimbursement Impact

• Accurate coding of fatty liver affects claim acceptance by aligning diagnosis with billed services such as imaging, labs, and counseling.
• Common denial reasons when K76.0 is used incorrectly include mismatched documentation (e.g., documentation supports NASH or alcoholic disease), missing medical necessity for ordered tests, and absence of linked symptoms or monitoring.
• Medical necessity requirements tied to this diagnosis often demand documentation of relevant symptoms, abnormal labs, or risk factors justifying testing and specialty referrals.
• Payer-specific guidelines to be aware of include differing definitions of NASH, prior authorization triggers for advanced fibrosis testing, and criteria for obesity-related counseling coverage.

Compliance Considerations

• Audit risk areas related to fatty liver coding include unsupported specificity, failure to code alcohol-related conditions appropriately, and lack of documentation for interventions billed.
• Documentation standards for compliance require clear problem lists, visit assessment language matching coded diagnosis, and evidence of evaluation or management tied to the diagnosis.
• Upcoding and undercoding risks: assigning NASH or cirrhosis without supporting evidence constitutes upcoding; using a nonspecific K76.0 when documentation supports a more specific code may understate patient complexity.
• Guidelines from CMS and major commercial payers emphasize documentation of diagnosis, linkage to services, and use of specific codes when etiology or severity is documented.

Accurate ICD-10 coding is critical for healthcare revenue cycle performance. CombineHealth.ai's AI-powered platform helps RCM teams ensure coding accuracy, reduce denials, and optimize reimbursement through intelligent denial management and claim validation. CombineHealth.ai's intelligent platform provides automated claim scrubbing and coding validation to catch errors before submission, reducing denials and improving first-pass acceptance rates.

FAQs

Q1: What is the ICD-10 code for fatty liver?
The ICD-10-CM code for fatty liver is K76.0. Use this code when clinical documentation or imaging reports hepatic steatosis without specification of cause (alcoholic disease, NASH) or complications.

Q2: When should I use K76.0 vs related codes?
Use K76.0 for nonspecific fatty change. Use Alcoholic fatty liver (K70.0) when alcohol is the documented cause, use Nonalcoholic steatohepatitis (K75.81) when inflammation/steatohepatitis is diagnosed, and select cirrhosis codes (for example, K74.60) when fibrosis or cirrhosis is present. Always follow documentation hierarchy: etiology first, then complications.

Q3: What documentation is required when coding for fatty liver?
Document the specific term used (fatty liver, NASH, alcoholic fatty liver), relevant laboratory or imaging findings, etiology (alcohol use, metabolic risk factors), and any interventions or monitoring plans. For advanced testing or therapies, document medical necessity and prior authorization requirements.

Q4: What are common denial reasons when coding for fatty liver?
Denials commonly stem from lack of specificity (K76.0 used when NASH or alcoholic disease is supported), missing linkage between diagnosis and billed services, absent documentation of medical necessity for tests, and failure to address payer-specific requirements. See our guide on denial management for approaches to reduce these denials.