K74 — Fibrosis and Cirrhosis of Liver: ICD-10 Code Explained

The code K74 on a discharge summary, referral or appointment slip is hard to read calmly, so let us name it plainly: it is the category «Fibrosis and cirrhosis of liver». In everyday language the word «cirrhosis» sounds like a final verdict; in the classification it means something narrower — the degree of scarring in liver tissue, which has stages, causes and very different scenarios. Below, without alarm and without understatement: what K74 literally means, where it appears, what it does and does not say about your liver, how the subcategories and neighbouring codes differ, and what a reasonable next step looks like.

What ICD 10 code K74 means: fibrosis and cirrhosis of liver

The official wording of K74 is «Fibrosis and cirrhosis of liver». Taken apart:

• K — the letter of ICD-10 Class XI, «Diseases of the digestive system» (K00–K93). The liver belongs to the digestive system, so its diseases live here rather than among infections.
• K70–K77 — the block «Diseases of liver». Inside it, codes are split primarily by cause: K70 alcoholic liver disease, K71 toxic liver disease, K73 chronic hepatitis not elsewhere classified, K76 other diseases of liver.
• K74 — the category describing the result of damage: working liver tissue replaced by scar tissue. It deliberately groups fibrosis and cirrhosis together, because they form one line — from isolated strands of scar to a complete rebuilding of the organ with regenerative nodules.
• The digit after the decimal point — stage and type: .0 hepatic fibrosis, .1 hepatic sclerosis, .2 fibrosis with sclerosis, .3 primary biliary cirrhosis, .4 secondary biliary cirrhosis, .5 biliary cirrhosis unspecified, .6 other and unspecified cirrhosis of liver.

Put together, K74 records «there is scarring in the liver». The code states the condition of the tissue and nothing else: not the cause, not the severity, not whether the liver is coping with its work today. The cause is almost always carried by a separate code, next to it or on the neighbouring line of the document.

Where you may have seen this code

ICD codes are written for statistics and reimbursement rather than for the patient, so they turn up in very different papers:

An important caveat: the code reflects what was written at the moment the document was issued. It may be provisional, carried over from an older summary, or entered more broadly than needed — K74.6 instead of a specified subcategory, for instance. Substance lies in the text of the conclusion, the ultrasound and elastography findings and the laboratory results, not in the code in the header.

Is it serious: what the code says about your condition

Plainly, without alarm and without understatement.

What the code does mean. Scarring has been recorded in the liver. It develops over years and almost always silently: the liver itself does not hurt, and its functional reserve is large, so a person feels well for a long time. Cirrhosis is the far end of that line, where not only the composition of the tissue changes but also the architecture of the organ and the blood flow through it. That is why monitoring in cirrhosis targets specific things: pressure in the portal system, the veins of the oesophagus, blood counts and the risk of liver cancer. How the disease itself unfolds is covered in the article on liver cirrhosis.

What the code does not mean.

• K74 is not necessarily cirrhosis. The subcategory K74.0 is fibrosis — an earlier stage. The digit after the point is the part worth reading.
• It says nothing about severity. Cirrhosis can be compensated, with the liver still doing its job and the person living an ordinary life for years, or decompensated, with ascites, jaundice and encephalopathy. Those are fundamentally different situations under one code.
• It does not name the cause. Viral hepatitis, alcohol, fatty liver disease, autoimmune and inherited conditions all produce the same scarring picture but call for different management. The cause is always coded separately.
• It does not mean «irreversible». Early fibrosis can regress once the cause is removed: hepatitis C cured, alcohol stopped, weight and metabolic factors corrected in fatty liver disease. Established cirrhosis does not unwind, but its progression slows and its complications are preventable through monitoring.
• It is not a prognosis. Neither timeline nor scenario follows from a code: too much depends on the cause, the stage and whether the damaging factor has been removed.

If the code appeared unexpectedly and no confirmatory investigation was done, ask the facility on what basis it was entered: «increased echogenicity» or «diffuse changes» on an ultrasound report is not enough to establish cirrhosis.

Neighbouring codes and how they differ

Within block K70–K77 codes differ primarily by the cause of damage, and nearby categories cover complications and outcomes.

Three frequent confusions are worth separating. First, B18 — chronic viral hepatitis — is a cause, not a synonym for K74; the two codes often sit side by side, each answering for its own part of the picture. Second, fatty liver disease is coded as K76.0 in its own right and moves into K74 only once fibrosis has formed. Third, the upper abdominal pain that brought a person in for testing frequently has nothing to do with the liver — acute pain more often belongs to the pancreas (K85) or the gallbladder (K81), while a fibrotic liver usually does not hurt at all.

Tests usually ordered with ICD 10 code K74

The panel is decided by the physician, but the usual logic is: confirm and stage the scarring, assess how the liver works, find the cause and catch complications in time.

Most of these tests are done in an ordinary laboratory on referral, while specialist follow-up is led by a gastroenterologist or hepatologist. Numbers on a report almost always look worse without explanation than with it: normal enzymes in cirrhosis are an ordinary finding, not evidence that the concern was misplaced.

What to do next

A calm, practical sequence:

1. Read the digit after the decimal point. K74.0 is fibrosis and K74.6 is cirrhosis without further specification — different stages that should not be merged in your head.
2. Establish the cause. It determines what can be changed: viral hepatitis is treatable, alcohol-related and fatty liver damage respond to removing the factor, autoimmune and inherited forms have their own management.
3. Build the full picture of the liver. Which markers belong to a basic assessment and what each of them means is set out in the guide to liver blood tests.
4. Clarify whether the cirrhosis is compensated. Severity is judged from bilirubin, albumin, INR, ascites and encephalopathy — the parameters combined by the Child-Pugh score; it is a reference point for the conversation with your doctor, not a diagnosis in itself.
5. Keep scheduled follow-up. In cirrhosis the point of regular visits is to see complications before they announce themselves; the interval is set by the physician.
6. Agree a plan with a gastroenterologist or hepatologist. Treatment, its regimen and its timing are decided from your results; no reference page, this one included, prescribes anything.

The short version

K74 is the ICD-10 code for scarring of the liver: the category is worded «Fibrosis and cirrhosis of liver». The digit after the point separates the stage — K74.0 fibrosis, K74.6 cirrhosis unspecified. The code records the state of the tissue and carries no cause, no severity and no prognosis; compensated and decompensated cirrhosis look identical on paper. The substantive answers come from elastography, liver markers, the search for a cause — and from a physician who has ways to influence how the process runs.