ICD-10 Coding for Hyperkalemia(E87.5, E87.72)
Complete ICD-10-CM coding and documentation guide for Hyperkalemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperkalemia
E87.5Primary Range
Disorders of potassium metabolism
This range includes hyperkalemia, which is the primary condition of interest.
Other fluid, electrolyte and acid-base balance disorders
Includes specific conditions like hyperkalemia due to missed dialysis.
Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end stage renal disease
Used when hyperkalemia is associated with hypertensive CKD.
Type 2 diabetes mellitus with other specified kidney complication
Relevant when hyperkalemia is due to diabetic kidney complications.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E87.5 | Hyperkalemia | Use when hyperkalemia is confirmed by lab and clinical findings. |
|
| E87.72 | Hyperkalemia due to missed dialysis | Use when hyperkalemia is directly linked to a missed dialysis session. |
|
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 hyperkalemia
Essential facts and insights about Hyperkalemia
Primary ICD-10-CM Codes for hyperkalemia
Decision Criteria
clinical Criteria
- Presence of serum potassium ≥5.5 mmol/L with symptoms or ECG changes.
documentation Criteria
- Clinician documentation confirming hyperkalemia.
Applicable To
- High potassium levels
Excludes
- Hypokalemia (E87.6)
Clinical Validation Requirements
- Serum potassium level ≥5.5 mmol/L
- ECG changes such as peaked T-waves
Code-Specific Risks
- Coding based solely on lab values without clinical confirmation.
Coding Notes
- Ensure clinical documentation supports the diagnosis of hyperkalemia beyond lab values.
E87.72 - Hyperkalemia due to missed dialysis
Use when hyperkalemia is directly linked to a missed dialysis session.
Applicable To
- Hyperkalemia in patients missing dialysis
Excludes
- Hyperkalemia not related to dialysis (E87.5)
Clinical Validation Requirements
- Documentation of missed dialysis session
- Serum potassium level ≥6.0 mmol/L
Coding Notes
Ensure linkage to missed dialysis is documented.
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 Hyperkalemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E87.5.
Impact
Clinical: Incomplete clinical assessment., Regulatory: Non-compliance with coding guidelines., Financial: Potential for reduced reimbursement.
Mitigation Strategy
Always assess and document underlying conditions., Use appropriate codes for related conditions.
Impact
Reimbursement: May lead to denied claims if not properly documented., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure clinician documentation confirms hyperkalemia.
Impact
Reimbursement: Potential underpayment due to incorrect DRG assignment., Compliance: Failure to follow ICD-10 sequencing rules., Data Quality: Incomplete clinical picture.
Mitigation Strategy
Document and code CKD when it contributes to hyperkalemia.
Impact
Risk of coding errors due to insufficient documentation.
Mitigation Strategy
Implement thorough documentation practices and regular audits.
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 Hyperkalemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperkalemia
Use these documentation templates to ensure complete and accurate documentation for Hyperkalemia. These templates include all required elements for proper coding and billing.
Nephrology consultation for hyperkalemia
Specialty: NephrologyRequired Elements
- Patient history
- Current medications
- Lab results
- ECG findings
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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