ICD-10 K76.7
Billable / Specific HCC v28: 27 MCCHepatorenal syndrome
About ICD-10-CM K76.7
ICD-10-CM code K76.7 represents Hepatorenal syndrome. This is a billable/specific code in the Digestive System chapter (block K76). The 2026 edition of ICD-10-CM K76.7 became effective on October 1, 2025.
Coding Tips for K76.7
Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.
K76.7 is a CMS-HCC v28 risk-adjustment code (category 27). To count for the patient Risk Adjustment Factor (RAF), document the diagnosis with MEAT language each calendar year: Monitored, Evaluated, Assessed, Treated. A diagnosis on the problem list alone does not satisfy CMS RADV audit standards. Include the diagnosis in the assessment with current status and current treatment plan.
K76.7 is designated MCC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-MCC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag MCC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.
Type 1 Excludes
Pure excludes, these codes can never be coded together with K76.7. The conditions are mutually exclusive (e.g., congenital vs acquired forms).
- hepatorenal syndrome following labor and delivery (O90.41)
- postprocedural hepatorenal syndrome (K91.83)
Medicare Advantage HCC Impact
Capture this diagnosis annually for accurate risk adjustment. Missed HCC captures are the #1 revenue leak in Medicare Advantage risk programs.
Inpatient DRG Impact, MCC
codes Hepatorenal syndrome. As a Major Complication/Comorbidity (MCC), this can shift the DRG assignment to a higher-weighted category, substantial reimbursement impact.
Medicare LCD Coverage for K76.7
Local Coverage Determinations (LCDs) from CMS MACs that list K76.7 as a covered diagnosis.
Showing top 10 of 170 total . Click a CPT for full coverage scope.
Commercial Payer Coverage
Coverage policies from major commercial payers referencing K76.7.
1 Cigna
5 Medicare
CPT Codes Commonly Billed with K76.7
Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.
- J2353 CMS LCD: Billing and Coding: Octreotide Acetate for Injectable Suspension (Sandostatin� LAR Depot) CMS LCD
Convert K76.7 to ICD-9-CM
Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.
| ICD-10 | ICD-9 | Mapping Flags |
|---|---|---|
| K76.7 | 5724 | 00000 |
Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).
Codes Adjacent To K76.7
Other codes in section K70-K77 (Diseases of liver).
ICD-10 K76.7, Billing FAQ
Is ICD-10 code K76.7 billable? +
Yes, K76.7 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.
What codes are Type 1 Excludes for K76.7? +
Type 1 Excludes (never code together with K76.7): hepatorenal syndrome following labor and delivery (O90.41); postprocedural hepatorenal syndrome (K91.83)
Does K76.7 affect Medicare Advantage HCC risk adjustment? +
Yes. K76.7 maps to CMS-HCC v28 category 27. Capture this diagnosis annually for accurate Medicare Advantage risk score.
Is K76.7 a CC or MCC for inpatient DRG? +
Yes, this code is designated as MCC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.
What CPT codes are commonly billed with K76.7? +
Procedures frequently paired with K76.7 include: J2353.
What ICD-9 codes does K76.7 map to? +
Per CMS GEMs, K76.7 maps to ICD-9 codes: 5724. Useful for legacy data review and historical claim analysis.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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