K76.0: Fatty (change of) liver, not elsewhere classified

The ICD-10-CM code for fatty liver, reported for hepatic steatosis, nonalcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease, when the record documents steatosis without steatohepatitis and without an alcoholic cause.

Billable

FY2027

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At a glance

Code Family

K76: Other diseases of liver.

Condition

Fatty liver

DRG Grouping

MS-DRG 441, 442 or 443 in MDC 07 under the FY2027 MS-DRG v44 grouper, depending on the complications and comorbidities reported with it.

HCC Mapping (v28)

None. K76.0 is absent from the CMS-HCC Version 28 diagnosis to condition category crosswalk. It returns no risk adjustment value.

Family Specificity

Thirteen billable codes in category K76, each naming a specific liver lesion, with K76.0 for fatty change and K76.9 as the residual code for liver disease of unstated type.

Billable

Yes. K76.0 has no child codes. It is valid in the FY2026 code set and unchanged in the FY2027 update.

Which K76 code do I assign?

Category K76 splits on the specific liver lesion the note names, not on how severe the liver disease is. The fatty liver decision itself turns on two axes that reach outside K76: the documented cause of the steatosis, and whether steatohepatitis is documented.

When documentation says…

Code

Hepatic steatosis with cardiometabolic risk factors and no significant alcohol use

K76.0

Fatty change of the liver from a metabolic cause. The note must name the fatty liver or the steatosis as a diagnosis. It must not document steatohepatitis.

MASLD or NAFLD named in the assessment

K76.0

Metabolic dysfunction-associated steatotic liver disease and nonalcoholic fatty liver disease are both inclusion terms under K76.0 in the FY2027 tabular. Either wording supports the code without a query.

NASH, MASH or nonalcoholic steatohepatitis

K75.81

Steatohepatitis is inflammation with hepatocellular injury, which classifies to the inflammatory liver disease category K75. The Excludes1 note at K76.0 forbids reporting K76.0 with K75.81 for the same liver disease.

Alcoholic fatty liver, or fatty liver the provider attributes to alcohol

K70.0

Alcoholic fatty liver. The alcoholic form sits in category K70, which carries a Use additional code instruction for alcohol abuse and dependence (the F10 codes).

Steatosis with no organ named

E88.89

Other specified metabolic disorders. The FY2027 Alphabetic Index leads from the unqualified main term Steatosis to E88.89. The subterm for liver leads to K76.0. The note must state the organ.

Liver disease with no type, cause or lesion stated

K76.9

Liver disease, unspecified. Reserve K76.9 for records that give nothing more specific than liver disease.

Tabular notes

EXCLUDES1

Excludes1: nonalcoholic steatohepatitis (NASH) (K75.81). An Excludes1 note means not coded here. K76.0 and K75.81 are never reported together for the same liver disease. When the provider documents steatohepatitis, K75.81 replaces K76.0.

EXCLUDES2

Category K76 carries Excludes2 notes for 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) and toxic liver disease (the K71 codes). An Excludes2 note means not included here. The patient may carry both conditions. Both may be reported when both are documented. Fatty liver with a documented alcoholic cause is classified to K70.0 rather than K76.0, because the alcoholic etiology places the diagnosis in category K70.

FY2027: EFFECTIVE 1 OCTOBER 2026

K76.0 is valid in the FY2026 code set and unchanged in the FY2027 update, which took effect on 1 October 2026. Its inclusion terms remain metabolic dysfunction-associated steatotic liver disease (MASLD) and nonalcoholic fatty liver disease (NAFLD). K75.81 carries metabolic dysfunction-associated steatohepatitis (MASH) as an inclusion term. FY2027 has no separate code for MASLD, MASH or MetALD, and the Alphabetic Index has no entry for MetALD. FY2027 added one code to category K76: K76.83, Intestinal failure-associated liver disease, with an Excludes1 note for intestinal failure (K90.83).

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+)

None. K76.0 does not appear in the CMS-HCC Version 28 diagnosis to condition category crosswalk published with the CMS-HCC model software.

K75.81, nonalcoholic steatohepatitis, carries no Version 28 category either. Neither simple steatosis nor steatohepatitis risk adjusts.

The liver conditions that do map under Version 28 sit further along the disease course. K74.60, unspecified cirrhosis of liver, maps to HCC 64, Cirrhosis of Liver. K76.6, portal hypertension, maps to HCC 63, Chronic Liver Failure and End-Stage Liver Disorders. K70.10, alcoholic hepatitis without ascites, maps to HCC 65, Chronic Hepatitis.

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

MS-DRG v44 (FY2027)

MS-DRG 441: disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with MCC.

MS-DRG 442: disorders of liver except malignancy, cirrhosis or alcoholic hepatitis with CC.

MS-DRG 443: disorders of liver except malignancy, cirrhosis or alcoholic hepatitis without CC or MCC.

K76.0 as a principal diagnosis groups to MS-DRG 441, 442 or 443 in MDC 07, diseases and disorders of the hepatobiliary system and pancreas. The tier follows the secondary diagnoses reported on the claim.

Medicare and commercial payers

There is no National Coverage Determination specific to fatty liver diagnosis coding. K76.0 carries no procedure-specific billing restriction unique to the diagnosis code.

WHERE SPECIFICITY IS LOST

Reporting K76.0 when the provider documented steatohepatitis understates the hepatic diagnosis. The Excludes1 note at K76.0 means the two are not reported together for the same liver disease. K75.81 is the correct single code.

Reporting K76.0 when the provider documented an alcoholic cause misses category K70 and its Use additional code instruction for alcohol abuse and dependence (the F10 codes).

Neither K76.0 nor K75.81 returns risk adjustment value. Some cardiometabolic comorbidities documented alongside the fatty liver map under Version 28, such as type 2 diabetes mellitus without complications (E11.9) in HCC 38. They are coded separately.

SEVERITY DESIGNATION (MS-DRG V44.0)

K76.0 carries no severity designation. It appears in neither Appendix G, the CC list, nor Appendix H, the MCC list, of the ICD-10 MS-DRG Definitions Manual Version 44.0. A case reaches the higher tier of its DRG pair on a designation carried by another diagnosis.

Documentation checklist to support K76.0

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

A provider statement naming the fatty liver, the hepatic steatosis, MASLD or NAFLD as a diagnosis, rather than an imaging finding standing on its own.

The absence of documented steatohepatitis. FY2027 Official Guidelines Section I.A.19 bases code assignment on the provider's diagnostic statement. A biopsy or elastography result does not by itself support K75.81.

An alcohol history sufficient to rule the alcoholic etiology in or out, because a documented alcoholic cause moves the encounter to K70.0.

The cardiometabolic criteria the provider relied on, such as body mass index, fasting glucose or HbA1c, blood pressure, triglycerides and HDL cholesterol.

Codes for the documented metabolic comorbidities, reported separately.

Any staged fibrosis result, which supports a code from K74.0- alongside K75.81 when steatohepatitis is the documented diagnosis.

The organ, when the note says only steatosis, because the FY2027 Alphabetic Index sends the unqualified main term to E88.89.

For outpatient encounters, a confirmed diagnosis. FY2027 Official Guidelines Section IV.H 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 K76.0 a billable ICD-10-CM code?

Yes. K76.0 is a billable code with no child codes. It is valid for claims with dates of service from 1 October 2026 through 30 September 2027 under the FY2027 code set.

What is the ICD-10 code for MASLD?

MASLD codes to K76.0. Metabolic dysfunction-associated steatotic liver disease (MASLD) is an inclusion term under K76.0 in the FY2027 tabular. ICD-10-CM has not created a separate MASLD code. Nonalcoholic fatty liver disease (NAFLD) remains an inclusion term under the same code. Both terms land on K76.0.

When do I use K75.81 instead of K76.0?

Use K75.81 when the provider documents nonalcoholic steatohepatitis, NASH or MASH. Steatohepatitis is inflammation with hepatocellular injury, which is a different diagnosis from simple fatty change. K76.0 carries an Excludes1 note for K75.81. The two are never reported together for the same liver disease.

What code applies to alcoholic fatty liver?

Alcoholic fatty liver codes to K70.0, Alcoholic fatty liver. Category K76 carries an Excludes2 note for alcoholic liver disease (K70.-), which places the alcoholic form outside K76. Category K70 also carries a Use additional code instruction for alcohol abuse and dependence (the F10 codes).

Does K76.0 map to an HCC?

No. K76.0 does not appear in the CMS-HCC Version 28 diagnosis to condition category crosswalk. It returns no risk adjustment value. K75.81 carries no Version 28 category either. Cirrhosis coded to K74.60 maps to HCC 64, Cirrhosis of Liver.

Is there an ICD-10 code for MetALD?

No. ICD-10-CM has no code for metabolic and alcohol-related steatotic liver disease through the FY2026 release. The FY2027 release effective 1 October 2026 adds no steatotic liver disease code either. Where a note documents both a metabolic and an alcoholic driver, query the provider for the etiology that supports the diagnosis, because K76.0 and K70.0 sit in different categories.

How is K76.0 sequenced?

K76.0 is sequenced as the principal diagnosis when the fatty liver is the condition chiefly responsible for the admission or the encounter. It is sequenced as a secondary diagnosis when the encounter is for another condition. K76.0 carries no Code first or Use additional code instruction in the FY2027 tabular. The tabular imposes no sequencing on it.

Does K76.0 work differently for inpatient and outpatient coding?

The code itself is the same. FY2027 Official Guidelines Section IV.H prohibits reporting probable or suspected fatty liver 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 K76.0 also drives MS-DRG assignment to 441, 442 or 443.

Related codes

Codes in the same family as K76.0. Only codes with a published page render as links.

Sibling codes in the K76 family

K76.1: Chronic passive congestion of liver.
K76.2: Central hemorrhagic necrosis of liver.
K76.3: Infarction of liver.
K76.4: Peliosis hepatis.
K76.5: Hepatic veno-occlusive disease.
K76.6: Portal hypertension.
K76.7: Hepatorenal syndrome.
K76.81: Hepatopulmonary syndrome.
K76.82: Hepatic encephalopathy.
K76.83: Intestinal failure-associated liver disease.
K76.89: Other specified diseases of liver.
K76.9: Liver disease, unspecified.

Additional codes to consider

Codes outside the K76 family considered alongside K76.0.

Consider instead

K75.81: Nonalcoholic steatohepatitis (NASH), where steatohepatitis is the documented diagnosis.
K70.0: Alcoholic fatty liver, where an alcoholic cause is documented.
K71.9: Toxic liver disease, unspecified, where a drug or a toxin is the documented cause.
K74.60: Unspecified cirrhosis of liver, where cirrhosis is documented.
K74.00: Hepatic fibrosis, unspecified, coded after K75.81 under the Code first note at K74.0.
K76.9: Liver disease, unspecified, where no lesion and no cause is stated.
E88.89: Other specified metabolic disorders, where the index leads from an unqualified steatosis.

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