K74.60: Unspecified cirrhosis of liver

The ICD-10-CM code for liver cirrhosis when the record establishes cirrhosis but documents no alcoholic, toxic, cardiac, hereditary or congenital cause and names no morphologic pattern.

Billable

FY2027

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At a glance

Code Family

K74: Fibrosis and cirrhosis of liver.

Condition

Liver cirrhosis

HCC Mapping (v28)

HCC 64, Cirrhosis of Liver. HCC 63 supersedes it whenever a code that maps to HCC 63 is also reported, such as K76.82 or K72.10.

DRG Grouping

MS-DRG 432, 433 or 434 in MDC 07 under the FY2027 MS-DRG v44 grouper, depending on the complications and comorbidities also reported.

Family Specificity

Eleven billable codes in category K74 on two axes, the lesion the note names and the cause or pattern behind it, with K74.60 as the residual code for cirrhosis of unstated type.

Billable

Yes. K74.60 is a five character leaf code with no children. It is valid in the FY2026 code set and unchanged in the FY2027 update.

Which K74 code do I assign?

Category K74 splits first on the lesion the note names: hepatic fibrosis, hepatic sclerosis or cirrhosis. It splits again on the cause or the morphologic pattern behind that lesion. The largest decision sits outside the family, because the Excludes1 note at K74 sends a documented alcoholic, toxic, cardiac, hereditary or congenital cause to another category entirely.

When documentation says…

Code

Alcoholic cirrhosis, or cirrhosis the provider attributes to alcohol use

K70.30 or K70.31

Alcoholic cirrhosis of liver, without ascites or with ascites. The Excludes1 note at K74 settles this before any K74 code is considered. A documented alcoholic cause moves the diagnosis out of category K74 entirely. Category K70 then carries a Use additional code instruction for alcohol abuse and dependence (the F10 codes).

Cirrhosis of liver, with no cause and no pattern stated

K74.60

Unspecified cirrhosis of liver. Cirrhosis of liver NOS is the printed inclusion term. Reserve K74.60 for records that establish cirrhosis and go no further. Cirrhosis attributed to chronic viral hepatitis also sits here, reported with the hepatitis code under the Code also note at K74.

Cryptogenic, macronodular, micronodular, mixed type, portal or postnecrotic cirrhosis

K74.69

Other cirrhosis of liver. All six wordings are printed inclusion terms at K74.69 in the FY2027 tabular. A named morphologic pattern is specificity the record already carries. Assigning K74.60 discards it.

Decompensated cirrhosis, or cirrhosis with ascites, encephalopathy, varices or hepatorenal syndrome

K74.60

Unspecified cirrhosis of liver, sequenced first, with each manifestation coded additionally. ICD-10-CM carries no code for decompensated cirrhosis. The word itself changes nothing in the K74 selection. Ascites is R18.8, hepatic encephalopathy is K76.82, varices secondary to cirrhosis are I85.10 or I85.11 and hepatorenal syndrome is K76.7. When the provider documents hepatic decompensation, the Index entry Decompensation, hepatic says see Failure, hepatic. That entry defaults to K72.90, with subterms for alcoholic (K70.40), drug-induced (K71.10) and postprocedural (K91.82) hepatic failure.

Hepatic fibrosis on biopsy or elastography, without cirrhosis

K74.00, K74.01, K74.0A or K74.02

Hepatic fibrosis, unspecified, early fibrosis, moderate fibrosis or advanced fibrosis. FY2027 added K74.0A for moderate fibrosis, stage F2, and limited K74.01 to stage F1. Subcategory K74.0 carries a Code first note for the underlying liver disease, such as nonalcoholic steatohepatitis (K75.81). Advanced fibrosis is not cirrhosis. The FY2027 tabular keeps the two lesions in separate subcategories.

Primary biliary cholangitis, secondary biliary cirrhosis or biliary cirrhosis NOS

K74.3, K74.4 or K74.5

Primary biliary cirrhosis, secondary biliary cirrhosis or biliary cirrhosis, unspecified. Primary biliary cholangitis is a printed inclusion term at K74.3, which still carries the older descriptor. The three do not share a risk adjustment category. K74.4 maps to HCC 64 while K74.3 and K74.5 map to HCC 68.

Drug induced cirrhosis, toxic cirrhosis or cardiac cirrhosis

K71.7 or K76.1

Toxic liver disease with fibrosis and cirrhosis of liver, or chronic passive congestion of liver for cardiac cirrhosis. Both appear in the Excludes1 list at K74. Category K71 carries a Code first note for the poisoning and a Use additional code note for the adverse effect.

Tabular notes

EXCLUDES1

Excludes1 at category K74: alcoholic cirrhosis of liver (K70.3), alcoholic fibrosis of liver (K70.2), cardiac sclerosis of liver (K76.1), cirrhosis of liver with toxic liver disease (K71.7), congenital cirrhosis of liver (P78.81) and pigmentary cirrhosis of liver (E83.110). An Excludes1 note means not coded here. None of these six is ever reported with K74.60 for the same liver disease. Each names a cause that ICD-10-CM classifies outside category K74. A documented cause moves the diagnosis rather than adding a second code. The note is inherited by every code in the category, K74.60 included.

CODE ALSO

Code also, if applicable, viral hepatitis, acute or chronic (B15-B19). Viral hepatitis is handled as a Code also rather than an Excludes1. Cirrhosis due to chronic viral hepatitis is therefore reported as K74.60 plus the hepatitis code. Chronic viral hepatitis C is B18.2. Chronic viral hepatitis B without delta-agent is B18.1. Sequencing follows the reason for the encounter. This is the one documented etiology that keeps the case inside K74 rather than moving it out.

FY2027: EFFECTIVE 1 OCTOBER 2026

K74.60 is valid in the FY2026 code set and unchanged in the FY2027 update, which took effect on 1 October 2026. FY2027 added K74.0A, Hepatic fibrosis, moderate fibrosis, with the inclusion terms hepatic fibrosis, stage F2 and moderate hepatic fibrosis. K74.01 now lists hepatic fibrosis, stage F1 and mild hepatic fibrosis. The Excludes1 and Code also notes at K74 are unchanged. The FY2027 tabular carries no entry for decompensated cirrhosis, at K74 or elsewhere in chapter 11. Decompensation is reported through the manifestation codes alongside K74.60.

Operational & financial impact

Why specificity matters beyond the chart: risk adjustment, DRG assignment and denial exposure all follow from which code is selected.

CMS-HCC v28 (PY2024+)

K74.60 maps to CMS-HCC Version 28 category HCC 64, Cirrhosis of Liver, in the diagnosis to condition category crosswalk published with the CMS-HCC model software.

K74.69, K74.4, K70.30 and K70.31 map to HCC 64 as well. The documented cause changes the code, the Use additional code instructions and the DRG inputs. It does not change the risk adjustment category.

K74.3 and K74.5 sit elsewhere. Both map to HCC 68, Cholangitis and Obstruction of Bile Duct Without Gallstones.

HCC 64 sits below HCC 63 in the Version 28 hierarchy. A code that maps to HCC 63 supersedes it for the payment year. K72.10, K72.11, K76.6, K76.7, K76.82, I85.10 and I85.11 all map to HCC 63, Chronic Liver Failure and End-Stage Liver Disorders.

The hepatic fibrosis codes K74.00, K74.01 and K74.02 carry no Version 28 category. Neither do K74.1, K74.2 or R18.8 for ascites. K74.0A is new in FY2027 and postdates the crosswalk. Its status is indeterminate.

CMS-HCC Version 28 is the operative payment model for payment year 2026.

For Medicare Advantage risk adjustment the cirrhosis must be documented as actively managed each calendar year. The code must appear on a dated encounter note rather than only on a problem list.

MS-DRG v44 (FY2027)

MS-DRG 432: cirrhosis and alcoholic hepatitis with MCC.

MS-DRG 433: cirrhosis and alcoholic hepatitis with CC.

MS-DRG 434: cirrhosis and alcoholic hepatitis without CC or MCC.

K74.60 as a principal diagnosis groups to MS-DRG 432, 433 or 434 in MDC 07, diseases and disorders of the hepatobiliary system and pancreas. The tier follows the secondary diagnoses reported on the claim.

K70.30 and K70.31 group to the same three DRGs. The alcohol distinction is visible in the code and in risk adjustment recapture rather than in the DRG.

K76.0 and the other lesions in category K76, except K76.81 (hepatopulmonary syndrome), group instead to MS-DRG 441, 442 or 443, disorders of liver except malignancy, cirrhosis or alcoholic hepatitis.

Medicare and commercial payers

K74.60 is a valid billable code and is not rejected as an incomplete code.

There is no National Coverage Determination specific to cirrhosis diagnosis coding.

Section I.B.18 of the FY2027 ICD-10-CM Official Guidelines directs that unspecified codes be reported when they are the codes that most accurately reflect what is known about the patient's condition at that encounter.

WHERE SPECIFICITY IS LOST

Reporting K74.60 where the provider documented alcohol as the cause conflicts with the Excludes1 note at K74. K70.30 or K70.31 is the correct single code. Category K70 adds a Use additional code instruction for alcohol abuse and dependence (the F10 codes).

Reporting K74.60 alone where the record documents ascites, hepatic encephalopathy, varices or hepatorenal syndrome drops the decompensation. Each manifestation is reported as an additional code. Several of them move the case from HCC 64 to HCC 63.

Reporting K74.60 where the note names a morphologic pattern discards it. Cryptogenic, macronodular, micronodular, mixed type, portal and postnecrotic cirrhosis are printed inclusion terms at K74.69.

Reporting K74.60 where hepatic fibrosis is the documented lesion overstates it. Fibrosis without cirrhosis codes to K74.00, K74.01, K74.0A or K74.02 by stage. K74.00, K74.01 and K74.02 carry no Version 28 category. K74.0A postdates the crosswalk.

Reporting K74.60 where a drug or a toxin is the documented cause misses K71.7. Category K71 carries a Code first note for the poisoning and a Use additional code note for the adverse effect.

Documentation checklist to support K74.60

Chart elements that support code selection and reduce specificity-driven denials.

A provider statement naming cirrhosis of the liver as a diagnosis, rather than a biopsy, elastography or imaging read standing on its own. Section I.A.19 of the FY2027 ICD-10-CM Official Guidelines bases code assignment on the provider's diagnostic statement.

An alcohol history stated plainly enough to rule the alcoholic etiology in or out, because a documented alcoholic cause moves the encounter to K70.30 or K70.31.

The etiology where one is established, such as chronic viral hepatitis, metabolic dysfunction-associated steatohepatitis, autoimmune hepatitis, a biliary cause or hereditary hemochromatosis.

Any named morphologic pattern, because cryptogenic, macronodular, micronodular, mixed type, portal and postnecrotic cirrhosis are inclusion terms at K74.69.

Each decompensation event named individually: ascites, hepatic encephalopathy, esophageal or gastric varices, hepatorenal syndrome, portal hypertension and spontaneous bacterial peritonitis.

For varices, whether they are bleeding, because that is the distinction between I85.10 and I85.11.

A statement of hepatic failure and its acuity where present. Chronic hepatic failure codes to K72.10 or K72.11 and carries the inclusion term end stage liver disease.

Evidence of active clinical management within the calendar year, to support annual recapture of HCC 64 under CMS-HCC Version 28.

For outpatient encounters, a confirmed diagnosis. Section IV.H of the FY2027 Official Guidelines prohibits reporting probable or suspected conditions in the outpatient setting. Section II.H allows a diagnosis documented as uncertain at inpatient discharge to be coded as confirmed.

FAQ

Is K74.60 a billable ICD-10-CM code?

Yes. K74.60 is a five character leaf code with no children and is billable for dates of service from 1 October 2026 through 30 September 2027 under the FY2027 code set. It is the code the FY2027 tabular carries for cirrhosis of liver NOS.

What is the ICD-10 code for decompensated liver cirrhosis?

There is no single code. The FY2027 tabular carries no entry for decompensated cirrhosis anywhere in chapter 11. Report K74.60 for the cirrhosis, then add a code for each documented manifestation: R18.8 for ascites, K76.82 for hepatic encephalopathy, I85.10 or I85.11 for secondary esophageal varices, K76.7 for hepatorenal syndrome, K76.6 for portal hypertension and K65.2 for spontaneous bacterial peritonitis. When the provider documents hepatic decompensation, the Index entry Decompensation, hepatic says see Failure, hepatic. That entry defaults to K72.90, with subterms for alcoholic (K70.40), drug-induced (K71.10) and postprocedural (K91.82) hepatic failure.

When do I use K70.30 or K70.31 instead of K74.60?

Use K70.30 or K70.31 whenever the provider documents alcohol as the cause. The Excludes1 note at K74 lists alcoholic cirrhosis of liver (K70.3), which means K74.60 and the alcoholic codes are never reported together for the same liver disease. K70.30 is without ascites and K70.31 is with ascites. The alcoholic branch therefore carries ascites in the code itself rather than in a separate R18.8.

Do I code ascites separately with K74.60?

Yes. Ascites is coded separately with R18.8, Other ascites. ICD-10-CM provides combination codes only for the alcoholic and toxic forms. The Excludes1 note at R18 bars R18.8 only with K70.31, K70.11 and K71.51. No note bars R18.8 with K74.60. Category K72 carries an explicit Use additional code instruction for ascites (R18.8), which shows the same intent for non-alcoholic liver disease.

Does K74.60 map to an HCC?

Yes. K74.60 maps to HCC 64, Cirrhosis of Liver, under CMS-HCC Version 28, the operative model for payment year 2026. HCC 64 is superseded in the Version 28 hierarchy by HCC 63, Chronic Liver Failure and End-Stage Liver Disorders. Reporting K72.10, K76.6, K76.7, K76.82, I85.10 or I85.11 alongside K74.60 moves the case to that higher category.

How is K74.60 sequenced with esophageal varices?

K74.60 is sequenced first. Varices caused by cirrhosis are secondary varices, coded I85.10 without bleeding or I85.11 with bleeding. Subcategory I85.1 carries a Code first instruction for the underlying disease. Esophageal varices secondary to cirrhosis of liver is a printed inclusion term at I85.1. The primary codes I85.00 and I85.01 are for idiopathic varices with no underlying liver disease.

Did anything change for K74.60 in FY2027?

K74.60 is unchanged in the FY2027 update, effective 1 October 2026. That update adds K74.0A for moderate hepatic fibrosis, stage F2, and limits K74.01 to stage F1. FY2026, effective 1 October 2025, added, deleted and revised nothing in category K74. The April 1, 2026 mid-year addendum introduced no new diagnosis codes and reaches nothing in K74.

Does K74.60 work differently for inpatient and outpatient coding?

The code selection is the same. The sequencing rules differ. Section IV.H of the FY2027 Official Guidelines prohibits coding a probable or suspected cirrhosis in the outpatient setting. Section II.H allows a diagnosis documented as uncertain at inpatient discharge to be coded as confirmed. On the inpatient side K74.60 as principal diagnosis drives MS-DRG 432, 433 or 434.

Related codes

Codes in the same family as K74.60. Only codes with a published page render as links.

Sibling codes in the K74 family

K74.00: Hepatic fibrosis, unspecified.
K74.01: Hepatic fibrosis, early fibrosis.
K74.0A: Hepatic fibrosis, moderate fibrosis.
K74.02: Hepatic fibrosis, advanced fibrosis.
K74.1: Hepatic sclerosis.
K74.2: Hepatic fibrosis with hepatic sclerosis.
K74.3: Primary biliary cirrhosis.
K74.4: Secondary biliary cirrhosis.
K74.5: Biliary cirrhosis, unspecified.
K74.69: Other cirrhosis of liver.

Additional codes to consider

Codes outside the K74 family considered alongside K74.60.

Companion: code alongside when documented

R18.8: Other ascites.
K76.82: Hepatic encephalopathy.
I85.10: Secondary esophageal varices without bleeding.
I85.11: Secondary esophageal varices with bleeding.
I86.4: Gastric varices.
K76.6: Portal hypertension.
K76.7: Hepatorenal syndrome.
K72.10: Chronic hepatic failure without coma.
K72.11: Chronic hepatic failure with coma.
K65.2: Spontaneous bacterial peritonitis.
B18.2: Chronic viral hepatitis C, reported under the Code also note at K74.

Consider instead

K70.30: Alcoholic cirrhosis of liver without ascites, where alcohol is the documented cause.
K70.31: Alcoholic cirrhosis of liver with ascites, where alcohol is the documented cause and ascites is present.
K71.7: Toxic liver disease with fibrosis and cirrhosis of liver, where a drug or a toxin is the documented cause.
K76.1: Chronic passive congestion of liver, which carries cardiac sclerosis of liver.
E83.110: Hereditary hemochromatosis, which carries pigmentary cirrhosis of liver.
P78.81: Congenital cirrhosis (of liver).
K74.69: Other cirrhosis of liver, where a morphologic pattern or cryptogenic cirrhosis is named.
K76.0: Fatty (change of) liver, not elsewhere classified, the earlier point on the same disease course.
K76.9: Liver disease, unspecified, where cirrhosis is not established.

Sources

All claims on this page derive from government and professional-standards sources.

National Center for Health Statistics. (2026). International classification of diseases, tenth revision, clinical modification (ICD-10-CM) FY2027 files. https://www.cdc.gov/nchs/icd/icd-10-cm/files.html
Centers for Medicare & Medicaid Services and National Center for Health Statistics. (2026). ICD-10-CM official guidelines for coding and reporting FY2027. https://ftp.cdc.gov/pub/Health_Statistics/NCHS/Publications/ICD10CM/2027/ICD-10-CM-October-1-2026-FY27-Guidelines.pdf
Centers for Medicare & Medicaid Services. (2025). 2026 model software/ICD-10 mappings. https://www.cms.gov/medicare/payment/medicare-advantage-rates-statistics/risk-adjustment/2026-model-software-icd-10-mappings
Centers for Medicare & Medicaid Services. (2026). MS-DRG classifications and software, version 44. https://www.cms.gov/medicare/payment/prospective-payment-systems/acute-inpatient-pps/ms-drg-classifications-and-software