ICD-10 Coding for Abnormal Laboratory Values(R73.09, R74.0)
Complete ICD-10-CM coding and documentation guide for Abnormal Laboratory Values. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Laboratory Values
R70-R79Primary Range
Abnormal findings on examination of blood, without diagnosis
This range covers various abnormal blood test results that are not linked to a specific diagnosis.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R73.09 | Other abnormal glucose | Use when glucose levels are elevated but diabetes is not diagnosed. |
|
| R74.0 | Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH] | Use when liver enzymes are elevated without a specific liver disease diagnosis. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for abnormal glucose
Essential facts and insights about Abnormal Laboratory Values
Primary ICD-10-CM Codes for abnormal laboratory values
Decision Criteria
clinical Criteria
- Glucose level >140 mg/dL without diabetes
Applicable To
- Elevated glucose without a diabetes diagnosis
Excludes
- Diabetes mellitus (E08-E13)
Clinical Validation Requirements
- Glucose level >140 mg/dL without a diabetes diagnosis
Code-Specific Risks
- Misuse when diabetes is confirmed
Coding Notes
- Ensure documentation specifies glucose levels and absence of diabetes diagnosis.
R74.0 - Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH]
Use when liver enzymes are elevated without a specific liver disease diagnosis.
Applicable To
- Elevated liver enzymes
Excludes
- Liver disease (K70-K77)
Clinical Validation Requirements
- ALT >3x ULN
Coding Notes
Document enzyme levels and absence of liver disease diagnosis.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abnormal Laboratory Values to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R73.09.
Impact
Clinical: May lead to misdiagnosis or inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Always include a clinical interpretation of lab results., Ensure provider reviews and signs off on lab reports.
Impact
Reimbursement: May lead to lower reimbursement rates., Compliance: Could result in non-compliance with coding guidelines., Data Quality: Reduces the specificity and usefulness of health data.
Mitigation Strategy
Identify and use the most specific code available for the abnormal finding.
Impact
High risk of audit when unspecified codes are used without justification.
Mitigation Strategy
Use specific codes whenever possible and document justification for any unspecified codes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abnormal Laboratory Values, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Laboratory Values
Use these documentation templates to ensure complete and accurate documentation for Abnormal Laboratory Values. These templates include all required elements for proper coding and billing.
Documenting Elevated Glucose
Specialty: EndocrinologyRequired Elements
- Test type and result
- Reference range
- Clinical interpretation
- Provider signature
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Abnormal Laboratory Values? Ask your questions below.