ICD-10 Coding for Food Intolerance(E73.9, K90.41, K52.2)
Complete ICD-10-CM coding and documentation guide for Food Intolerance. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Food Intolerance
E73.-Primary Range
Lactose intolerance codes
Covers lactose intolerance conditions, including unspecified and congenital lactase deficiency.
Malabsorption due to intolerance
Includes non-celiac gluten sensitivity and other malabsorption syndromes due to intolerance.
Allergic and dietetic gastroenteritis and colitis
Used for Food Protein-Induced Enterocolitis Syndrome (FPIES).
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E73.9 | Lactose intolerance, unspecified | Use when lactose intolerance is confirmed without specifying type. |
|
| K90.41 | Non-celiac gluten sensitivity | Use when gluten sensitivity is confirmed and celiac disease is excluded. |
|
| K52.2 | Allergic and dietetic gastroenteritis and colitis | Use for FPIES diagnosis with typical delayed reaction. |
|
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 lactose intolerance
Essential facts and insights about Food Intolerance
Primary ICD-10-CM Codes for food intolerance
Decision Criteria
clinical Criteria
- Positive hydrogen breath test for lactose malabsorption
documentation Criteria
- Exclusion of IgE-mediated allergy
Applicable To
- Lactase deficiency
Excludes
- Milk allergy (Z91.011)
Clinical Validation Requirements
- Hydrogen breath test showing ≥20ppm over baseline
- Documented lactase deficiency
Code-Specific Risks
- Confusion with milk allergy codes
Coding Notes
- Ensure documentation specifies lactase deficiency and excludes IgE-mediated allergies.
K90.41 - Non-celiac gluten sensitivity
Use when gluten sensitivity is confirmed and celiac disease is excluded.
Applicable To
- Gluten sensitivity without celiac disease
Excludes
- Celiac disease (K90.0)
Clinical Validation Requirements
- Negative tTG-IgA and normal duodenal biopsy
- Symptom resolution on gluten-free diet
Coding Notes
Document exclusion of celiac disease and symptom improvement on gluten-free diet.
K52.2 - Allergic and dietetic gastroenteritis and colitis
Use for FPIES diagnosis with typical delayed reaction.
Applicable To
- Food Protein-Induced Enterocolitis Syndrome (FPIES)
Excludes
- Infectious gastroenteritis
Clinical Validation Requirements
- ≥2 episodes of delayed vomiting post-ingestion
- Exclusion of infectious causes
Coding Notes
Ensure documentation includes exclusion of infectious causes and typical FPIES presentation.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Food Intolerance to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E73.9.
Impact
Clinical: Misleading clinical records, Regulatory: Non-compliance with coding standards, Financial: Denied claims due to incorrect coding
Mitigation Strategy
Verify allergy testing results, Use intolerance-specific codes
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate patient records and data reporting.
Mitigation Strategy
Ensure documentation specifies lactase deficiency and excludes IgE-mediated reactions.
Impact
Reimbursement: Potential for incorrect DRG assignment., Compliance: Violation of coding standards., Data Quality: Misleading clinical data.
Mitigation Strategy
Confirm negative serology and biopsy for celiac disease before coding K90.41.
Impact
Risk of using allergy codes instead of intolerance codes.
Mitigation Strategy
Ensure documentation specifies lactase deficiency and excludes IgE-mediated reactions.
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 Food Intolerance, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Food Intolerance
Use these documentation templates to ensure complete and accurate documentation for Food Intolerance. These templates include all required elements for proper coding and billing.
Documenting lactose intolerance
Specialty: GastroenterologyRequired Elements
- Patient symptoms
- Hydrogen breath test results
- Exclusion of IgE-mediated allergies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Non-celiac gluten sensitivity
Specialty: GastroenterologyRequired Elements
- Symptom description
- Celiac serology results
- Dietary intervention outcomes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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