ICD-10 Coding for Gilbert's Syndrome(E80.4)
Complete ICD-10-CM coding and documentation guide for Gilbert's Syndrome. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gilbert's Syndrome
E80.0-E80.9Primary Range
Disorders of bilirubin metabolism
This range includes conditions related to bilirubin metabolism, including Gilbert syndrome.
Key Information: ICD-10 code for Gilbert's syndrome
Essential facts and insights about Gilbert's Syndrome
Primary ICD-10-CM Code for gilbert's syndrome
Decision Criteria
clinical Criteria
- Unconjugated hyperbilirubinemia with normal liver enzymes
coding Criteria
- Ensure no mention of liver pathology
Applicable To
- Gilbert's syndrome
- Inherited disorder of bilirubin metabolism
Clinical Validation Requirements
- Unconjugated hyperbilirubinemia <6 mg/dL
- Normal liver enzymes (ALT/AST <40 U/L)
- Absence of hemolysis (normal LDH, haptoglobin)
- Episodic jaundice triggered by fasting, stress, or illness
Code-Specific Risks
- Confusion with other hyperbilirubinemias
- Incorrect documentation of jaundice due to liver disease
Coding Notes
- Always sequence E80.4 as primary for confirmed Gilbert’s.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Unspecified jaundice
R17Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Gilbert's Syndrome to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E80.4.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify unconjugated vs. conjugated bilirubin., Ensure lab results are included.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding standards., Data Quality: Inaccurate patient records.
Mitigation Strategy
Always code E80.4 when confirmed.
Impact
Risk of coding errors due to confusion with similar conditions.
Mitigation Strategy
Provide training on differentiating Gilbert syndrome from other hyperbilirubinemias.
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 Gilbert's Syndrome, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gilbert's Syndrome
Use these documentation templates to ensure complete and accurate documentation for Gilbert's Syndrome. These templates include all required elements for proper coding and billing.
Primary Care Visit
Specialty: Primary CareRequired Elements
- Total bilirubin levels
- Liver function tests
- Absence of hemolysis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for Gilbert's Syndrome? Ask your questions below.