Elevated liver enzymes show up in labs more often than people think. When AST and ALT are higher than normal, providers often document the condition as transaminitis. For coders and billers, this creates one big question. Which ICD 10 code should be used? This blog breaks it down in a clear and practical way so clinicians, coders, and healthcare teams can stay accurate and compliant.
What Is the ICD 10 Code for Transaminitis?
The primary ICD 10 code used for transaminitis is R74.01, which is defined as elevation of levels of liver transaminase levels. This code is the best match when the medical record clearly documents elevated AST or ALT without confirming a specific liver disease.
R74.01 falls under the symptoms and abnormal clinical and laboratory findings category. It should be used when lab abnormalities are present and are clinically relevant to the visit or testing ordered.
Related ICD 10 Codes for Transaminitis
Another commonly used related code is R74.8, which represents other abnormal levels of serum enzymes. This code may be used when abnormal enzymes are documented but transaminases are not specifically named.
In some cases, providers may document abnormal liver function tests rather than transaminitis. If no specific enzyme is identified, coders must carefully review documentation before selecting a code. Once a definitive liver condition is diagnosed, symptom codes like R74.01 should be replaced with the confirmed diagnosis code.
Services Are Covered Under the Transaminitis ICD 10 Code
The ICD 10 code R74.01 supports medical necessity for diagnostic and monitoring services. These commonly include hepatic function panels, repeat liver enzyme testing, imaging such as abdominal ultrasound, and specialist referrals.
It may also justify follow up visits and additional lab work to determine the underlying cause. Coverage always depends on payer policies, but proper documentation of elevated liver enzymes improves claim acceptance.
Coding History for Transaminitis
Before ICD 10, transaminitis was often coded using less specific abnormal lab result codes under ICD 9. The transition to ICD 10 improved specificity by separating transaminase elevation from other enzyme abnormalities.
R74.01 was introduced to clearly identify elevated AST and ALT levels. This change helped improve data accuracy, reporting, and clinical tracking of liver related findings across healthcare systems.
Usage Instructions for Coding Transaminitis
R74.01 should be used only when elevated transaminase levels are documented by the provider. Lab results alone are not enough unless the provider links them to the assessment or plan.
This code is appropriate for initial evaluations, follow up visits, and monitoring when no definitive diagnosis has been made. If a cause is identified later, coders should update the diagnosis code accordingly.
Includes Guidelines for R74.01
This code includes elevated AST levels, elevated ALT levels, and documented transaminitis. It also includes abnormal liver enzyme findings when transaminases are clearly specified in the clinical note.
The documentation must show that the abnormal lab value is clinically relevant to the encounter.
Excludes Guidelines for R74.01
R74.01 should not be used when a specific liver disease has been diagnosed. Conditions such as fatty liver disease, hepatitis, alcoholic liver disease, or cirrhosis require their own ICD 10 codes.
It should also not be used for abnormal enzymes unrelated to liver transaminases. In those cases, R74.8 or another appropriate abnormal lab code may be more accurate.
