ICD-10 Coding for Elevated Bilirubin(R17, E80.6, K71.89, P58.0)
Complete ICD-10-CM coding and documentation guide for Elevated Bilirubin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Bilirubin
Hereditary bilirubin metabolism disorders
Applicable for conditions like Gilbert syndrome with unconjugated hyperbilirubinemia.
Toxic liver disease with hyperbilirubinemia
Used when liver dysfunction is due to toxin exposure.
Hemolytic disease of newborn due to isoimmunization
Used for neonatal jaundice due to blood group incompatibility.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R17 | Unspecified jaundice | Use when jaundice is observed but the cause is not determined. |
|
| E80.6 | Hereditary bilirubin metabolism disorders | Use when hereditary disorders like Gilbert syndrome are diagnosed. |
|
| K71.89 | Toxic liver disease with hyperbilirubinemia | Use when liver dysfunction is confirmed to be due to toxin exposure. |
|
| P58.0 | Neonatal jaundice due to isoimmunization | Use for neonatal jaundice confirmed to be due to blood group incompatibility. |
|
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 bilirubin
Essential facts and insights about Elevated Bilirubin
Primary ICD-10-CM Codes for elevated bilirubin
Decision Criteria
clinical Criteria
- Jaundice present without specific diagnosis
Applicable To
- Jaundice NOS
Excludes
- Neonatal jaundice (P59.-)
Clinical Validation Requirements
- Presence of jaundice without a specific cause
Code-Specific Risks
- May lead to undercoding if the underlying cause is not investigated.
Coding Notes
- Ensure to document any potential underlying causes for accurate coding.
E80.6 - Hereditary bilirubin metabolism disorders
Use when hereditary disorders like Gilbert syndrome are diagnosed.
Applicable To
- Gilbert syndrome
Excludes
- Jaundice NOS (R17)
Clinical Validation Requirements
- Unconjugated bilirubin >1.2 mg/dL with normal liver function tests
Coding Notes
Document genetic testing or family history supporting hereditary diagnosis.
K71.89 - Toxic liver disease with hyperbilirubinemia
Use when liver dysfunction is confirmed to be due to toxin exposure.
Applicable To
- Liver dysfunction due to toxins
Excludes
- Viral hepatitis (B15-B19)
Clinical Validation Requirements
- Elevated liver enzymes with documented toxin exposure
Coding Notes
Ensure documentation includes specific toxin and liver function test results.
P58.0 - Neonatal jaundice due to isoimmunization
Use for neonatal jaundice confirmed to be due to blood group incompatibility.
Applicable To
- ABO incompatibility
Excludes
- Neonatal jaundice NOS (P59.9)
Clinical Validation Requirements
- Positive Coombs test with rising bilirubin levels
Coding Notes
Ensure documentation includes Coombs test results and bilirubin levels.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other disorders of bilirubin metabolism
E80.7Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated Bilirubin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R17.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding guidelines., Financial: Potential loss of reimbursement.
Mitigation Strategy
Ensure thorough clinical evaluation and documentation., Use specific codes when the cause is known.
Impact
Reimbursement: May lead to lower reimbursement due to non-specific coding., Compliance: Risk of non-compliance with coding guidelines., Data Quality: Decreases accuracy of clinical data.
Mitigation Strategy
Use R17 with underlying cause if known.
Impact
Reimbursement: Potential loss of reimbursement for specific neonatal conditions., Compliance: Non-compliance with specificity requirements., Data Quality: Reduces specificity in neonatal care data.
Mitigation Strategy
Use P58.0 with specific cause if identified.
Impact
Risk of audits due to non-specific coding of jaundice.
Mitigation Strategy
Ensure documentation supports specific ICD-10 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 Elevated Bilirubin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Bilirubin
Use these documentation templates to ensure complete and accurate documentation for Elevated Bilirubin. These templates include all required elements for proper coding and billing.
Neonatal Hyperbilirubinemia
Specialty: PediatricsRequired Elements
- Bilirubin levels
- Coombs test results
- Blood type compatibility
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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