Billing codes · ICD-10-CM code

K76.0 fatty liver (MASLD) and K75.81 (MASH) on nutrition claims

By Javier Alvarez · Updated September 28, 2026 · 4 min read

Fatty liver referrals now arrive under two vocabularies. A hepatologist writes "MASLD" or "MASH," a primary care note from two years ago says "NAFLD," and your claim needs one code. The good news: the renaming didn't create new codes. The catch: steatosis and steatohepatitis are still different codes, and fibrosis coding changed on October 1, 2026.

The renaming, and what it did to the codes

In June 2023, a multisociety consensus led by the liver associations (AASLD, EASL and ALEH) renamed nonalcoholic fatty liver disease MASLD (metabolic dysfunction-associated steatotic liver disease) and nonalcoholic steatohepatitis MASH (metabolic dysfunction-associated steatohepatitis), under the umbrella term steatotic liver disease.

ICD-10-CM followed in the FY2026 update, effective October 1, 2025. It didn't add codes. It added inclusion terms:

The index was updated the same way: "Disease, liver, metabolic dysfunction-associated steatotic (MASLD)" and "Steatohepatitis, metabolic dysfunction-associated (MASH)" point to K76.0 and K75.81. "Fatty liver NEC" and "steatosis, liver NEC" also go to K76.0.

Neither code changed in the FY2027 update effective October 1, 2026.

Choosing the right code

The guidelines code from the provider's documentation. Don't upgrade K76.0 to K75.81 because the labs look inflammatory, and don't turn "fatty liver on ultrasound" into MASH. If you need more specificity, ask the provider.

MetALD, the consensus category for people with MASLD who also drink more alcohol, has no code or index entry of its own in FY2027. Follow the provider's documentation and the index.

FY2027: fibrosis codes changed

Effective October 1, 2026, the hepatic fibrosis subcategory (K74.0-) was reorganized:

K75.81 carries a "use additional code, if applicable" note for hepatic fibrosis (K74.0-). If a MASH patient's referral says "stage F2 fibrosis" for a date of service on or after October 1, 2026, that's K75.81 + K74.0A. Before that date, it was K74.01.

The same update added K76.83, intestinal failure-associated liver disease (IFALD), which excludes intestinal failure (K90.83). It's relevant if you work with short bowel or home parenteral nutrition patients, not typical MASLD.

Coverage for fatty liver MNT

• Commercial plans. Aetna's CPB 0049 covers nutritional counseling for gastrointestinal disorders and other chronic conditions where dietary adjustment has a therapeutic role. Whether a specific plan accepts K76.0 as the lead diagnosis varies, so verify.
• Companion diagnoses. MASLD rarely travels alone. Obesity (E66.x with Z68), type 2 diabetes (E11.x), hyperlipidemia (E78.x), metabolic syndrome (E88.810) or hypertension often carry coverage, including preventive routing on plans like UnitedHealthcare that key on those codes.
• Medicare. MNT covers diabetes and renal disease only (NCD 180.1). A beneficiary with MASLD and type 2 diabetes qualifies on the diabetes code, with K76.0 as a secondary diagnosis.

For the business side of GI and liver referrals, see best nutrition niches for reimbursement. Many MASLD patients are also on GLP-1 medications; GLP-1 nutrition billing covers how those visits are coded.

Example claim lines (invented)

See E66 obesity, E11 type 2 diabetes and E78 hyperlipidemia for the companion codes.

What the note should show

• The provider's liver diagnosis in their words (and the imaging or biopsy result it rests on, as reported), plus any fibrosis stage.
• Weight history, measured weight and BMI, and the metabolic diagnoses that come with it.
• Alcohol intake as reported, since it changes the code.
• Diet pattern, added sugar and beverage intake, activity; your PES statement, plan (weight target, diet pattern), and face-to-face minutes.

Denials and fixes

For every diagnosis code on nutrition claims, see the ICD-10 codes for dietitians reference.