ICD-10 Coding for Milk Protein Intolerance(K90.4)
Complete ICD-10-CM coding and documentation guide for Milk Protein Intolerance. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Milk Protein Intolerance
K90-K95Primary Range
Other diseases of intestines
This range includes conditions related to malabsorption and digestive disorders, which encompass milk protein intolerance.
Personal history of allergy to other foods, drugs and biological substances
This range includes codes for documenting allergy status, which is relevant for distinguishing between allergy and intolerance.
Key Information: ICD-10 code for milk protein intolerance
Essential facts and insights about Milk Protein Intolerance
Primary ICD-10-CM Code for milk protein intolerance
Decision Criteria
clinical Criteria
- Presence of gastrointestinal symptoms without IgE-mediated reactions
documentation Criteria
- Detailed description of elimination diet response
Applicable To
- Milk protein intolerance
Excludes
- Z91.011 (Allergy to milk products)
Clinical Validation Requirements
- Symptoms like hematochezia, failure to thrive
- Positive response to elimination diet
- Endoscopy findings
Code-Specific Risks
- Confusion with allergy codes
- Inadequate documentation of symptoms
Coding Notes
- Ensure documentation specifies intolerance, not allergy.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Failure to thrive
R63.4Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Allergy to milk products
Z91.011Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Milk Protein Intolerance to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code K90.4.
Impact
Clinical: Misrepresentation of patient's condition, Regulatory: Non-compliance with coding guidelines, Financial: Potential claim denials
Mitigation Strategy
Educate staff on differences between allergy and intolerance, Use checklists for documentation
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Misclassification can affect compliance with coding standards., Data Quality: Impacts accuracy of patient records and data analysis.
Mitigation Strategy
Ensure documentation specifies non-IgE mediated reactions and gastrointestinal symptoms.
Impact
Using allergy codes for intolerance can trigger audits.
Mitigation Strategy
Ensure clear documentation of non-IgE mediated reactions.
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 Milk Protein Intolerance, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Milk Protein Intolerance
Use these documentation templates to ensure complete and accurate documentation for Milk Protein Intolerance. These templates include all required elements for proper coding and billing.
Pediatric patient with suspected milk protein intolerance
Specialty: PediatricsRequired Elements
- Symptom onset and description
- Elimination diet details
- Diagnostic test results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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