Information for Patients
What is hepatitis?
Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage your liver. This swelling and damage can affect how well your liver functions.
Hepatitis can be an acute (short-term) infection or a chronic (long-term) infection. Some types of hepatitis cause only acute infections. Other types can cause both acute and chronic infections.
What causes hepatitis?
There are different types of hepatitis, with different causes:
- Viral hepatitis is the most common type. It is caused by one of several viruses -- hepatitis viruses A, B, C, D, and E. In the United States, A, B, and C are the most common.
- Alcoholic hepatitis is caused by heavy alcohol use
- Toxic hepatitis can be caused by certain poisons, chemicals, medicines, or supplements
- Autoimmune hepatitis is a chronic type in which your body's immune system attacks your liver. The cause is not known, but genetics and your environment may play a role.
How is viral hepatitis spread?
Hepatitis A and hepatitis E usually spread through contact with food or water that was contaminated with an infected person's stool. You can also get hepatitis E by eating undercooked pork, deer, or shellfish.
Hepatitis B, hepatitis C, and hepatitis D spread through contact with the blood of someone who has the disease. Hepatitis B and D may also spread through contact with other body fluids. This can happen in many ways, such as sharing drug needles or having unprotected sex.
Who is at risk for hepatitis?
The risks are different for the different types of hepatitis. For example, with most of the viral types, your risk is higher if you have unprotected sex. People who drink a lot over long periods of time are at risk for alcoholic hepatitis.
What are the symptoms of hepatitis?
Some people with hepatitis do not have symptoms and do not know they are infected. If you do have symptoms, they may include:
- Loss of appetite
- Nausea and/or vomiting
- Abdominal pain
- Dark urine
- Clay-colored bowel movements
- Joint pain
- Jaundice, yellowing of your skin and eyes
If you have an acute infection, your symptoms can start anywhere between 2 weeks to 6 months after you got infected. If you have a chronic infection, you may not have symptoms until many years later.
What other problems can hepatitis cause?
Chronic hepatitis can lead to complications such as cirrhosis (scarring of the liver), liver failure, and liver cancer. Early diagnosis and treatment of chronic hepatitis may prevent these complications.
How is hepatitis diagnosed?
To diagnose hepatitis, your health care provider:
- Will ask about your symptoms and medical history
- Will do a physical exam
- Will likely do blood tests, including tests for viral hepatitis
- Might do imaging tests, such as an ultrasound, CT scan, or MRI
- May need to do a liver biopsy to get a clear diagnosis and check for liver damage
What are the treatments for hepatitis?
Treatment for hepatitis depends on which type you have and whether it is acute or chronic. Acute viral hepatitis often goes away on its own. To feel better, you may just need to rest and get enough fluids. But in some cases, it may be more serious. You might even need treatment in a hospital.
There are different medicines to treat the different chronic types of hepatitis. Possible other treatments may include surgery and other medical procedures. People who have alcoholic hepatitis need to stop drinking. If your chronic hepatitis leads to liver failure or liver cancer, you may need a liver transplant.
Can hepatitis be prevented?
There are different ways to prevent or lower your risk for hepatitis, depending on the type of hepatitis. For example, not drinking too much alcohol can prevent alcoholic hepatitis. There are vaccines to prevent hepatitis A and B. Autoimmune hepatitis cannot be prevented.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.