Elevated Liver Function Tests

[mbdk1977]

I have a question, if you saw elevated liver function tests on a report, what ICD-9 code would you assign for this?

[kumeena]

For clinic setting if you see it on assessment/plan I would code 790.6 (abn LFT)

[siddika_82@hotmail.com]

To my opinion I would not code for it unless the physician specifies it.... As we are not allowed to code from lab results.......

[mitchellde]

Originally Posted by siddika_82@hotmail.com

To my opinion I would not code for it unless the physician specifies it.... As we are not allowed to code from lab results.......

I agree! When you say you saw it on a report, if you are referring to a lab report then you leave it alone, but if you have the physician report where he states the liver enzymes were elevated then you code for the abnormal lab.

[kjohnson]

Maybe I'm wrong, but doesn't LFT stand for liver function test? Why wouldn't you code abnormal function study, liver 794.8?

[mitchellde]

yes that is what I meant when I said code the abnormal lab, in this case you would select the code for the elevated LFT but only if documented by the physician as elevated not from the lab report showing elevated.

[kjohnson]

I'm good with the physician has to document that the liver function test is abnormal to use it as a dx for the encounter. What about on the facility side, if you see the lab as being abnormal, but the doc doesn't use it in his final dx, can you pick it up and use it? Thank you in advance for your input!

[mitchellde]

even on the facility side if the only place you have the result is the lab report it cannot be coded it must be stated by the physician in his note. He does not necessarily need to use it as a final dx but it must be in his note the the liver enzymes were elevated.

[ohn0disaster]

The correct code selection for "elevated LFT" is 790.6, not 794.8.
Below is an easy to understand documented explanation of why.

The old FY2006 ICD-9-CM book featured a revised entry that clarified how to code “Liver Function Tests” and how they differed from “Liver Function Studies.” Since that time, it has been important that coders make a distinction between “tests” and “studies” – both the ICD-9-CM book and CodeRyte’s NLP software coding engine make the important distinction, too.

A brief overview:

The Alphabetical Index in the ICD-9-CM book was changed as of Oct. 1, 2005. There were two “new” entries that were added:

Elevation; liver function test (LFT), 790.6
Findings, abnormal; liver function test, 790.6
Now, as of Oct. 1, 2008, there is another clarifying entry:

Abnormal; liver function test, 790.6
Since FY2006 (with a bit of reinforcement for FY2009), "test" means "lab test" and isn't coded with the 794.8 code. An abnormal or elevated Liver Function Test would be coded as 790.6 if that is all that's documented. However, Abnormal liver function Studies or Scans are still 794.8 (because these are images, they can't really be “elevated”).

Abnormal; function study; liver, 794.8
Abnormal; scan; liver, 794.8
Findings, abnormal; function study; liver, 794.8
Findings, abnormal; scan; liver, 794.8

For more on the subject, follow this link.
http://www.coderyte.com/news/newslet...d-studies.html

[preserene]

As for my openion the code should have atleast some of the enzymes name attached to it.
The three digit code number is appropriate790. but the 4th digit .6 denotes abou tall the metals and minerals. It does not denote even a single emzymatic product there. Almost all metabolic products abnormality is excluded from this 4th digit- .6.
Could you please hav ealook at the 790.5 which shows abnormal serum levels of acid phosphatase, alkalin ephosphatase, amylase, lipase etc

After all, the elevated liver enzymes/ elevated or abnoraml liver function tests should show some/or all of these: ie, Four separate liver enzymes are included on most routine laboratory tests. They are- aspartate aminotransferase (AST or SGOT) and alanine aminotransferase (ALT or SGPT), which are known together as transaminases; and alkaline phosphatase (AP) and gamma-glutamyl transferase (GGT), which are known together as cholestatic liver enzymes. Elevations of these enzymes can indicate the presence of liver disease.