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ICD-10 Coding for Elevated Alkaline Phosphatase(R74.8, K83.1, M88.9)

Complete ICD-10-CM coding and documentation guide for Elevated Alkaline Phosphatase. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

Elevated ALPHigh Alkaline Phosphatasealkaline phosphatase elevationhigh alp levelsalk phos elevatedalp elevation

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Related ICD-10 Code Ranges

Complete code families applicable to Elevated Alkaline Phosphatase

R70-R79Primary Range

Abnormal findings on examination of blood, without diagnosis

This range includes codes for abnormal blood chemistry findings, including elevated alkaline phosphatase.

K70-K77

Diseases of liver

This range includes liver diseases that may cause elevated alkaline phosphatase.

M80-M94

Disorders of bone density and structure

This range includes bone disorders that may cause elevated alkaline phosphatase.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
R74.8Abnormal levels of other serum enzymesUse when elevated alkaline phosphatase is the primary finding without a known underlying condition.
  • ALP levels above 129 U/L for men or 104 U/L for women
  • Normal GGT and 5'-nucleotidase
K83.1Obstructive cholestasisUse when imaging confirms bile duct obstruction.
  • ALP >4x ULN
  • Dilated bile ducts on ultrasound
M88.9Paget's disease of bone, unspecifiedUse when X-ray confirms Paget's disease.
  • ALP >3x ULN
  • X-ray shows 'flame-shaped' lytic lesions

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 elevated alkaline phosphatase

Essential facts and insights about Elevated Alkaline Phosphatase

The ICD-10 code for elevated alkaline phosphatase is R74.8, used when no underlying condition is identified.

Primary ICD-10-CM Codes for elevated alkaline phosphatase

R74.8
Abnormal levels of other serum enzymes
Billable Code

Decision Criteria

clinical Criteria

  • ALP elevation with normal liver and bone markers

coding Criteria

  • No underlying condition identified

documentation Criteria

  • Documented ALP value and absence of other conditions

Applicable To

  • Isolated elevated alkaline phosphatase

Excludes

Clinical Validation Requirements

  • ALP levels above 129 U/L for men or 104 U/L for women
  • Normal GGT and 5'-nucleotidase

Code-Specific Risks

  • Incorrectly using R74.8 when an underlying condition is known

Coding Notes

  • Ensure documentation specifies the absence of liver or bone disease when using R74.8.
View Full Code Details

Ancillary Codes

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

Elevated lipoprotein(a)

E78.41
Use for cardiovascular risk stratification when ALP is normal.

Differential Codes

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

Obstructive cholestasis

K83.1
Use when imaging shows bile duct obstruction and conjugated hyperbilirubinemia.

Paget's disease of bone

M88.9
Use when X-ray shows 'flame-shaped' lytic lesions and bone pain.

Primary biliary cholangitis

K74.3
Use when AMA is positive and liver biopsy confirms diagnosis.

Other specified disorders of bone density and structure

M85.8
Use for other bone density disorders not specified as Paget's.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Elevated Alkaline Phosphatase to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R74.8.

Impact

Clinical: Lack of specificity can lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims.

Mitigation Strategy

Specify which enzymes are elevated, Provide quantitative values

Impact

Reimbursement: Incorrect DRG assignment may lead to reduced reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Code the underlying condition as primary and R74.8 as secondary if needed.

Impact

Using R74.8 as primary when an underlying condition exists.

Mitigation Strategy

Review clinical documentation for underlying conditions.

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 Elevated Alkaline Phosphatase, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Elevated Alkaline Phosphatase

Use these documentation templates to ensure complete and accurate documentation for Elevated Alkaline Phosphatase. These templates include all required elements for proper coding and billing.

Gastroenterology Progress Note

Specialty: Gastroenterology

Required Elements

  • Assessment
  • Plan
  • Lab results
  • Imaging findings

Example Documentation

Assessment: Elevated alkaline phosphatase (ALP 480 U/L, ref 40-129). Plan: Code K74.3 (Primary biliary cholangitis).

Examples: Poor vs. Good Documentation

Poor Documentation Example
Elevated ALP.
Good Documentation Example
ALP 450 U/L, 5x ULN, onset 3 weeks post-terbinafine initiation.
Explanation
The good example provides specific lab values and context.

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