2027 ICD-10-CM Diagnosis Code K76.81Hepatopulmonary syndrome
ICD-10-CM Codes›K00–K95›K70-K77›K76
- Billable — Valid for Submission
- Risk Adjusts — HCC 63
- Not a Principal Diagnosis
- Chronic Condition
K76.81 is a billable ICD-10-CM diagnosis code for hepatopulmonary syndrome. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 205 through 206. The code is not accepted as a principal diagnosis by the Medicare Code Editor. Coders also document this condition as dilatation of pulmonary artery. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Other specified and unspecified liver disease.
For Medicare Advantage risk adjustment, K76.81 maps to CMS-HCC Category 63 (Chronic Liver Failure/End-Stage Liver Disorders) under the V28 model, adding a risk factor of about 0.962 for a community, non-dual, aged beneficiary in payment year 2027.
Code Identity
Code Classification
Code EditsBilling
Medicare Code Editor checks that affect claim validity for K76.81.
Medicare Risk Adjustment (HCC)Billing
K76.81 maps to a payment category in the CMS-HCC model used to risk-adjust Medicare Advantage payments. Weights are the published community factors for payment year 2027.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Dilatation of pulmonary artery
- Hepatopulmonary syndrome
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to K76.81: its own notes plus those printed at K76, block K70-K77, and Chapter 11. A note printed at a category, block or chapter applies to every code under it.
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
- jaundice NOS (R17)
Excludes2
Not included here: the excluded condition is not part of this code, but a patient may have both, so both codes may be reported.
- certain conditions originating in the perinatal period (P04-P96)
- certain infectious and parasitic diseases (A00-B99)
- complications of pregnancy, childbirth and the puerperium (O00-O9A)
- congenital malformations, deformations and chromosomal abnormalities (Q00-Q99)
- endocrine, nutritional and metabolic diseases (E00-E88)
- injury, poisoning and certain other consequences of external causes (S00-T88)
- neoplasms (C00-D49)
- symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified (R00-R94)
Code First
The underlying condition named in the note is sequenced before this code.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Syndrome See Also: Disease;
hepatopulmonary K76.81
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Hepatopulmonary Syndrome
a syndrome characterized by the clinical triad of advanced chronic liver disease, pulmonary vascular dilatations, and reduced arterial oxygenation (hypoxemia) in the absence of intrinsic cardiopulmonary disease. this syndrome is common in the patients with liver cirrhosis or portal hypertension (hypertension, portal).
Patient EducationClinical
Liver Diseases
Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert K76.81 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About K76.81Overview
What is the ICD-10 code for hepatopulmonary syndrome?
The ICD-10-CM code for hepatopulmonary syndrome is K76.81 (sometimes written as K7681). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is K76.81 (Other specified diseases of liver) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report hepatopulmonary syndrome on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does K76.81 group to?
On inpatient claims, hepatopulmonary syndrome maps to MS-DRG 206, 205, with relative weights from 0.9255 to 1.8244 depending on complications. Higher weights mean higher Medicare reimbursement.
Can K76.81 be a principal diagnosis?
No. The Medicare Code Editor rejects this code as a principal diagnosis because hepatopulmonary syndrome describes a circumstance that influences health status rather than a current illness. Report it as a secondary diagnosis.
Can K76.81 be reported with R17?
Not as a rule. The Excludes1 note at block K70-K77, which applies to K76.81, lists "jaundice NOS (R17)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What HCC is K76.81?
K76.81 (hepatopulmonary syndrome) maps to CMS-HCC Category 63 (Chronic Liver Failure/End-Stage Liver Disorders), commonly written as HCC 63, in the CMS-HCC V28 model used for Medicare Advantage risk adjustment in payment year 2027. It mapped to HCC 27 under the retired V24 model. It also maps in the PACE (CMS-HCC V22), ESRD (V21), and ESRD (V24) models. It does not map to any RxHCC in the Part D prescription drug model.
Does K76.81 risk-adjust for Medicare Advantage payment?
Yes. When documented and reported on a Medicare Advantage encounter, K76.81 adds a risk adjustment factor of about 0.962 to the beneficiary's RAF score for a community, non-dual, aged enrollee (published V28 weights range from 0.861 to 1.209 depending on the payment segment). A more severe related category (HCC 62) supersedes it when both are reported. See the full factor table on the HCC 63 category page.
