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Esophageal varices due to liver cirrhosis

Coding and Physician Language:, February 7, 2007

  • Esophageal varices occur when a patient's lower esophageal veins become distended and twisted, causing bleeding.

 

  • Esophageal varices are commonly due to portal hypertension, but they can also be caused by cirrhosis of the liver.

 

  • A normal liver removes toxins from the body and produces clotting proteins. It plays a role in regulating the supply of glucose and fat that the body uses. In order for the liver to complete these tasks, the liver cells, which work very closely with the blood, need to function correctly. The scar tissue blocks the blood flow.

 

  • Cirrhosis causes the liver to function abnormally, resulting in a change of its structure. Blood cannot flow properly through the liver, resulting in a back up into the portal vein system, which causes portal hypertension.

 

  • When cells of the liver are injured or killed, the repair response causes scar tissue to form. Liver cells try to replace the necrotic ones where the scar tissue is forming, which results in a cluster of both liver cells and scar tissue.

 

  • A physician will diagnose esophageal varices due to liver cirrhosis via a laboratory blood draw and a liver biopsy.

 

  • When esophageal varices are connected with cirrhosis of the liver or portal hypertension, assign two codes-one for the esophageal varices and one for the underlying condition.

 

  • For example: a patient has bleeding esophageal varices with cirrhosis of the liver. Assign code 571.5 (Cirrhosis of the liver without mention of alcohol) followed by code 456.20 (Esophageal varices, with bleeding).

 

  • Likewise, when a patient has bleeding esophageal varices in portal hypertension, assign code 572.3 (Portal hypertension) followed by code 456.20 (Esophageal varices, with bleeding).

 

  • When a physician documents esophageal varices, cirrhosis of the liver, and portal hypertension, assign three codes-one for the varices, one for the cirrhosis, and one for the portal hypertension. List the appropriate underlying condition first.

 

  • For example, a patient has bleeding esophageal varices due to portal hypertension and cirrhosis of the liver. Assign code 572.3 then 571.5 then 456.20.

 

See also "esophageal varices due to portal hypertension."