ICD-10 Coding for G6PD Deficiency(D55.0, D75.A)
Complete ICD-10-CM coding and documentation guide for G6PD Deficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to G6PD Deficiency
D55-D59Primary Range
Acquired hemolytic anemias
This range includes codes for hemolytic anemias, including those due to enzyme deficiencies like G6PD.
Other and unspecified diseases of blood and blood-forming organs
This range includes codes for blood disorders not classified elsewhere, such as G6PD deficiency without anemia.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D55.0 | Anemia due to glucose-6-phosphate dehydrogenase [G6PD] deficiency | Use when anemia is directly caused by G6PD deficiency. |
|
| D75.A | Glucose-6-phosphate dehydrogenase [G6PD] deficiency without anemia | Use when G6PD deficiency is present without anemia. |
|
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 G6PD deficiency with anemia
Essential facts and insights about G6PD Deficiency
Primary ICD-10-CM Codes for glucose-6-phosphate-dehydrogenase
Decision Criteria
clinical Criteria
- Presence of hemolytic anemia and low G6PD enzyme activity
documentation Criteria
- Explicit mention of anemia due to G6PD deficiency
Clinical Validation Requirements
- Hemolytic anemia confirmed by lab tests
- G6PD enzyme activity <30% of normal
Code-Specific Risks
- Incorrectly coding without anemia documentation
Coding Notes
- Ensure anemia is documented and linked to G6PD deficiency.
D75.A - Glucose-6-phosphate dehydrogenase [G6PD] deficiency without anemia
Use when G6PD deficiency is present without anemia.
Applicable To
- Asymptomatic G6PD deficiency
Excludes
- Anemia due to G6PD deficiency (D55.0)
Clinical Validation Requirements
- G6PD enzyme activity test results
- Absence of anemia
Coding Notes
Ensure documentation clearly states the absence of anemia.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hemolytic anemia
R71.0Differential 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 G6PD Deficiency to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D55.0.
Impact
Clinical: Misrepresentation of patient's condition., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Review lab results before coding, Ensure documentation is complete
Impact
Reimbursement: Incorrect DRG assignment leading to potential overpayment., Compliance: Increased audit risk due to lack of supporting documentation., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Ensure anemia is documented and linked to G6PD deficiency.
Impact
Using D55.0 without anemia documentation increases audit risk.
Mitigation Strategy
Ensure thorough documentation of anemia and G6PD deficiency.
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 G6PD Deficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for G6PD Deficiency
Use these documentation templates to ensure complete and accurate documentation for G6PD Deficiency. These templates include all required elements for proper coding and billing.
Acute hemolytic episode due to G6PD deficiency
Specialty: HematologyRequired Elements
- Patient history
- Lab results
- Enzyme activity levels
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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