ICD-10 Coding for Hypoproteinemia(E88.09, R77.0)
Complete ICD-10-CM coding and documentation guide for Hypoproteinemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hypoproteinemia
E88.0-E88.09Primary Range
Metabolic disorders of plasma proteins
This range includes codes for disorders related to plasma protein metabolism, including hypoproteinemia.
Other abnormalities of plasma proteins
This range includes codes for abnormalities in plasma proteins, such as isolated albumin abnormalities.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E88.09 | Other disorders of plasma-protein metabolism, not elsewhere classified | Use when hypoproteinemia is due to metabolic disorders and is the primary concern. |
|
| R77.0 | Abnormality of albumin | Use when albumin is low but total protein is normal and no metabolic cause is documented. |
|
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 hypoproteinemia
Essential facts and insights about Hypoproteinemia
Primary ICD-10-CM Codes for hypoproteinemia
Decision Criteria
clinical Criteria
- Serum albumin <3.5 g/dL with documented metabolic disorder
coding Criteria
- Use E88.09 when hypoproteinemia is primary and not due to malnutrition.
Applicable To
- Hypoproteinemia
Excludes
- Protein-calorie malnutrition (E46)
Clinical Validation Requirements
- Serum albumin <3.5 g/dL
- Total protein <6.0 g/dL
Code-Specific Risks
- Incorrect sequencing if underlying cause is not documented.
Coding Notes
- Ensure documentation of serum protein levels and underlying causes.
R77.0 - Abnormality of albumin
Use when albumin is low but total protein is normal and no metabolic cause is documented.
Applicable To
- Isolated albumin abnormality
Excludes
- Hypoproteinemia due to metabolic disorder (E88.09)
Clinical Validation Requirements
- Albumin <3.5 g/dL
- Normal total protein levels
Coding Notes
Ensure documentation of isolated albumin abnormality without metabolic cause.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Generalized edema
R60.1Differential 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 Hypoproteinemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E88.09.
Impact
Clinical: Leads to misdiagnosis or inappropriate treatment., Regulatory: Fails to meet coding standards., Financial: Results in claim denials or reduced reimbursement.
Mitigation Strategy
Use specific lab values in documentation., Detail underlying causes and symptoms.
Impact
Reimbursement: Incorrect sequencing can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Document the underlying condition causing hypoproteinemia and sequence it first.
Impact
Failure to document and sequence underlying conditions first.
Mitigation Strategy
Educate coders on proper sequencing and documentation practices.
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 Hypoproteinemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hypoproteinemia
Use these documentation templates to ensure complete and accurate documentation for Hypoproteinemia. These templates include all required elements for proper coding and billing.
Nephrotic syndrome with hypoproteinemia
Specialty: NephrologyRequired Elements
- Serum albumin levels
- 24-hour urine protein
- Underlying condition
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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