Toxic liver disease with hepatic necrosis, without coma

This code signifies liver damage resulting from exposure to toxic substances, characterized by the death of liver cells (necrosis) but without the patient experiencing a comatose state. It represents acute or subacute liver failure directly attributable to toxins, such as certain medications, chemicals, or herbal remedies.

Apply this code when documentation clearly indicates liver necrosis caused by a toxic agent, and the patient is not in a coma. This includes cases of drug-induced liver injury (DILI) or chemical-induced hepatitis leading to cell death. Supporting documentation should specify the toxic exposure and the presence of necrosis.

• Ensure documentation explicitly states "necrosis" and rules out coma.
• Always code the specific toxic agent (e.g., T39.011A for acetaminophen poisoning) as an additional diagnosis.
• Differentiate from other forms of liver disease; this code is specific to toxic etiology with necrosis.