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ICD-10 Coding for AL Amyloidosis(E85.81, E85.89)

Complete ICD-10-CM coding and documentation guide for AL Amyloidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Amyloid Light-chain AmyloidosisPrimary Systemic Amyloidosis

Related ICD-10 Code Ranges

Complete code families applicable to AL Amyloidosis

E85.8-E85.9Primary Range

Other and unspecified amyloidosis

This range includes specific codes for AL amyloidosis and other types of amyloidosis.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
E85.81Light chain (AL) amyloidosisUse when AL amyloidosis is confirmed through clinical and laboratory findings.
  • Bone marrow biopsy showing monoclonal plasma cells
  • Abnormal serum free light chain ratio
E85.89Other amyloidosisUse when amyloidosis is confirmed but not specified as AL or another subtype.
  • Generic amyloidosis diagnosis without specific subtype confirmation

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 AL amyloidosis

Essential facts and insights about AL Amyloidosis

The ICD-10 code for AL amyloidosis is E85.81, used for confirmed cases with specific clinical findings.

Primary ICD-10-CM Codes for aluminum amyloid

Light chain (AL) amyloidosis
Billable Code

Decision Criteria

clinical Criteria

  • Presence of monoclonal protein and organ biopsy confirmation

Applicable To

  • Primary systemic amyloidosis

Excludes

  • Hereditary amyloidosis (E85.0)
  • Secondary amyloidosis (E85.1)

Clinical Validation Requirements

  • Bone marrow biopsy showing monoclonal plasma cells
  • Abnormal serum free light chain ratio

Code-Specific Risks

  • Confusion with ATTR amyloidosis
  • Incorrect documentation of amyloidosis type

Coding Notes

  • Ensure documentation specifies 'light chain' to avoid confusion with other amyloidosis types.

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Nephrotic syndrome, unspecified

N04.9
Use to specify renal involvement in AL amyloidosis.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Hereditary transthyretin-related amyloidosis

E85.82
Confirmed by genetic testing and absence of monoclonal proteins.

Light chain (AL) amyloidosis

E85.81
Confirmed by specific tests for monoclonal proteins.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting AL Amyloidosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E85.81.

Impact

Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for claim rejections.

Mitigation Strategy

Review biopsy and lab results for specificity, Educate staff on documentation standards

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data affecting patient care.

Mitigation Strategy

Ensure documentation specifies 'light chain' and confirm with appropriate tests.

Impact

High risk of audit if subtype is not specified.

Mitigation Strategy

Implement thorough documentation review processes.

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 AL Amyloidosis, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for AL Amyloidosis

Use these documentation templates to ensure complete and accurate documentation for AL Amyloidosis. These templates include all required elements for proper coding and billing.

Cardiac involvement in AL amyloidosis

Specialty: Cardiology

Required Elements

  • Serum FLC ratio
  • Cardiac MRI findings
  • Echocardiogram results

Example Documentation

Diagnosis: AL amyloidosis with cardiac involvement confirmed by elevated NT-proBNP and echocardiogram.

Examples: Poor vs. Good Documentation

Poor Documentation Example
Patient has amyloidosis.
Good Documentation Example
Patient has AL amyloidosis confirmed by serum FLC and cardiac MRI.
Explanation
The good example specifies the type of amyloidosis and supporting tests.

Need help with ICD-10 coding for AL Amyloidosis? Ask your questions below.

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