ICD-10 Coding for MTHFR Mutation(E72.12, O99.28)
Complete ICD-10-CM coding and documentation guide for MTHFR Mutation. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to MTHFR Mutation
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E72.12 | Methylenetetrahydrofolate reductase deficiency | Use when there is documented enzyme deficiency and clinical manifestations. |
|
| O99.28 | Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium | Use as primary code for pregnancy-related MTHFR complications. |
|
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 MTHFR mutation
Essential facts and insights about MTHFR Mutation
Primary ICD-10-CM Codes for mthfr mutation
Decision Criteria
clinical Criteria
- Presence of clinical symptoms and confirmed genetic mutation
coding Criteria
- Avoid using for asymptomatic genetic findings
Applicable To
- MTHFR deficiency with clinical manifestations
Excludes
- Asymptomatic MTHFR polymorphisms
Clinical Validation Requirements
- Genetic test confirming pathogenic variants
- Elevated homocysteine levels
- Clinical symptoms such as thrombosis or pregnancy loss
Code-Specific Risks
- Incorrectly coding asymptomatic carriers
Coding Notes
- Ensure clinical symptoms are documented before using E72.12.
O99.28 - Other specified diseases and conditions complicating pregnancy, childbirth and the puerperium
Use as primary code for pregnancy-related MTHFR complications.
Applicable To
- Metabolic disorders complicating pregnancy
Clinical Validation Requirements
- Pregnancy with documented MTHFR mutation and complications
Coding Notes
Always sequence as primary in pregnancy cases.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other specified abnormal findings of blood chemistry
R79.89Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Cystathionine beta-synthase deficiency
E72.11Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting MTHFR Mutation to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E72.12.
Impact
Clinical: Inadequate patient care, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure all symptoms are documented, Review genetic test results
Impact
Reimbursement: May lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Use Z84.89 for family history without symptoms.
Impact
Coding E72.12 without symptoms can trigger audits.
Mitigation Strategy
Use Z codes for asymptomatic cases.
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 MTHFR Mutation, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for MTHFR Mutation
Use these documentation templates to ensure complete and accurate documentation for MTHFR Mutation. These templates include all required elements for proper coding and billing.
Pregnancy with MTHFR mutation
Specialty: OB/GYNRequired Elements
- Genetic test results
- Clinical symptoms
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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