Current RMA Instruments
| Reasonable Hypothesis SOP | 1 of 2017 |
| Balance of Probabilities SOP | 2 of 2017 |
Changes from previous Instruments
ICD Coding
- ICD-9-CM Codes: 571.2, 571.5, 571.6, 573.3
- ICD-10-AM Codes: K70.3, K71.7, K74.3-K74.6
Brief description
Cirrhosis is a form of chronic liver disease in which normal liver tissue is replaced by scarring and nodules of regenerating liver cells. It is a final common pathway of many types of chronic liver injury.
Confirming the diagnosis
The diagnosis can be made based on the clinical, laboratory, and radiologic findings in combination. A liver biopsy is required for definitive diagnosis, but is generally not necessary if other findings strongly suggests the presence of cirrhosis.
The relevant medical specialist is a gastroenterologist or a hepatologist.
Diagnoses covered by SOP
- Alcoholic cirrhosis
- Biliary cirrhosis
- Cryptogenic cirrhosis
- Post-hepatitic cirrhosis
Conditions not covered by SOP
- Steatohepatitis*
* another SOP applies
Clinical onset
Cirrhosis is late stage liver disease, so the first symptoms, signs or other evidence of liver disease will not represent the clinical onset of cirrhosis. Clinical onset for cirrhosis will correspond to when the diagnosis (of cirrhosis) was first confirmed.
Clinical worsening
The course of cirrhosis is variable. Patients can be stabilised with appropriate treatment. However, patients with cirrhosis are susceptible to a variety of complications, and their life expectancy is markedly reduced. Cirrhosis is generally considered to be irreversible in its advanced stages, at which point the only treatment option may be liver transplantation. Reversal of cirrhosis in its earlier stages has been documented in some cases following treatment of the underlying cause.