ICD-10 Coding for Elevated Total Bilirubin(R17, E80.6, P59.9)
Complete ICD-10-CM coding and documentation guide for Elevated Total Bilirubin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Total Bilirubin
R17Primary Range
Unspecified jaundice
Used when hyperbilirubinemia is present without a specified cause.
Bilirubin metabolism disorders
Used for conditions like Gilbert's syndrome where there is a known metabolic disorder.
Neonatal jaundice, unspecified
Used for newborns with jaundice when the specific cause is not identified.
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 hyperbilirubinemia is present without a specified cause. |
|
| E80.6 | Bilirubin metabolism disorders | Use for metabolic disorders like Gilbert's syndrome. |
|
| P59.9 | Neonatal jaundice, unspecified | Use for newborns with jaundice when the specific cause is not identified. |
|
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 total bilirubin
Essential facts and insights about Elevated Total Bilirubin
Primary ICD-10-CM Codes for elevated total bilirubin
Decision Criteria
clinical Criteria
- Total bilirubin >1.3 mg/dL without specific cause
Applicable To
- Hyperbilirubinemia without specified cause
Clinical Validation Requirements
- Total bilirubin >1.3 mg/dL in adults without confirmed etiology
Code-Specific Risks
- Risk of undercoding if a specific cause is identified later.
Coding Notes
- Ensure no specific cause is documented before using R17.
E80.6 - Bilirubin metabolism disorders
Use for metabolic disorders like Gilbert's syndrome.
Applicable To
- Gilbert's syndrome
Excludes
- Neonatal jaundice (P59.9)
Clinical Validation Requirements
- Unconjugated hyperbilirubinemia with normal liver function tests
Coding Notes
Document genetic predisposition or family history.
P59.9 - Neonatal jaundice, unspecified
Use for newborns with jaundice when the specific cause is not identified.
Applicable To
- Neonatal jaundice without specified cause
Excludes
- Bilirubin metabolism disorders (E80.6)
Clinical Validation Requirements
- Total serum bilirubin >95th percentile on age-specific nomogram
Coding Notes
Document the bilirubin levels and age-specific nomogram percentile.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated Total Bilirubin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R17.
Impact
Clinical: Leads to inadequate diagnosis and treatment planning., Regulatory: May not meet coding compliance standards., Financial: Can affect reimbursement accuracy.
Mitigation Strategy
Always document specific bilirubin levels and fractions.
Impact
Reimbursement: May lead to incorrect DRG assignment., Compliance: Could result in audit issues., Data Quality: Affects accuracy of patient records.
Mitigation Strategy
Ensure all potential causes are ruled out before using R17.
Impact
Using R17 when a specific cause is documented.
Mitigation Strategy
Review all clinical documentation for potential causes before coding.
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 Total Bilirubin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Total Bilirubin
Use these documentation templates to ensure complete and accurate documentation for Elevated Total Bilirubin. These templates include all required elements for proper coding and billing.
Adult with suspected Gilbert's syndrome
Specialty: HepatologyRequired Elements
- Chief complaint
- History of present illness
- Family history
- Lab results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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