ICD-10 Coding for Lactose Intolerance(E73.0, E73.1, E73.8, E73.9)
Complete ICD-10-CM coding and documentation guide for Lactose Intolerance. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lactose Intolerance
E73Primary Range
Lactose intolerance
This range includes all codes related to lactose intolerance, covering congenital, secondary, and unspecified types.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E73.0 | Congenital lactase deficiency | Use when lactose intolerance is present from birth and confirmed by genetic testing. |
|
| E73.1 | Secondary lactase deficiency | Use when lactose intolerance is secondary to another condition like Crohn's disease. |
|
| E73.8 | Other lactose intolerance | Use for specified types of lactose intolerance not classified elsewhere. |
|
| E73.9 | Unspecified lactose intolerance | Use when lactose intolerance is diagnosed without specific etiology. |
|
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 Lactose Intolerance
Primary ICD-10-CM Codes for lactose intolerance
Decision Criteria
clinical Criteria
- Presence of congenital symptoms and genetic confirmation
Applicable To
- Congenital lactase deficiency
Excludes
- Secondary lactase deficiency (E73.1)
Clinical Validation Requirements
- Genetic testing confirming LCT-13910 CC genotype
- Failure to thrive in infancy
Code-Specific Risks
- Misclassification with secondary lactase deficiency
Coding Notes
- Ensure genetic confirmation is documented.
E73.1 - Secondary lactase deficiency
Use when lactose intolerance is secondary to another condition like Crohn's disease.
Applicable To
- Secondary lactase deficiency
Excludes
- Congenital lactase deficiency (E73.0)
Clinical Validation Requirements
- Temporal relationship with another condition
- Endoscopic findings supporting secondary cause
Coding Notes
Document the primary condition causing the deficiency.
E73.8 - Other lactose intolerance
Use for specified types of lactose intolerance not classified elsewhere.
Applicable To
- Other specified lactose intolerance
Excludes
- Unspecified lactose intolerance (E73.9)
Clinical Validation Requirements
- Specific etiology documented
- Age of onset >5 years
Coding Notes
Ensure specific etiology is documented.
E73.9 - Unspecified lactose intolerance
Use when lactose intolerance is diagnosed without specific etiology.
Applicable To
- Unspecified lactose intolerance
Excludes
- Other specified lactose intolerance (E73.8)
Clinical Validation Requirements
- Symptoms and dietary response documented
- Negative secondary workup
Coding Notes
Ensure lack of specific etiology is documented.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Secondary lactase deficiency
E73.1Congenital lactase deficiency
E73.0Unspecified lactose intolerance
E73.9Other lactose intolerance
E73.8Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Lactose Intolerance to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E73.0.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Ensure specific etiology is documented when available.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Misclassification affects regulatory compliance., Data Quality: Inaccurate data on patient conditions.
Mitigation Strategy
Use E73 codes for lactose intolerance and Z91.011 for milk allergy.
Impact
Frequent use of E73.9 without supporting documentation.
Mitigation Strategy
Ensure documentation supports the use of unspecified codes.
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 Lactose Intolerance, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lactose Intolerance
Use these documentation templates to ensure complete and accurate documentation for Lactose Intolerance. These templates include all required elements for proper coding and billing.
Gastroenterology Progress Note
Specialty: GastroenterologyRequired Elements
- Assessment of lactose intolerance
- Diagnostic test results
- Symptom correlation
- Management plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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