ICD-10 Coding for MTHFR Deficiency(E72.12)
Complete ICD-10-CM coding and documentation guide for MTHFR Deficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to MTHFR Deficiency
E70-E88Primary Range
Metabolic disorders
This range includes metabolic disorders, under which MTHFR deficiency is categorized.
Key Information: ICD-10 code for MTHFR deficiency
Essential facts and insights about MTHFR Deficiency
Primary ICD-10-CM Code for mthfr
Decision Criteria
clinical Criteria
- Presence of elevated homocysteine and confirmed mutation
Applicable To
- Homozygous C677T mutation
- Homozygous A1298C mutation
Excludes
- Asymptomatic MTHFR polymorphism
Clinical Validation Requirements
- Elevated homocysteine >15 µmol/L
- Confirmed genetic mutation via PCR
Code-Specific Risks
- Incorrectly coding asymptomatic carriers
Coding Notes
- Ensure documentation specifies mutation type and clinical impact.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Other thrombophilia
D68.69Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting MTHFR Deficiency to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E72.12.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Use specific mutation terminology, Include lab results
Impact
Reimbursement: Incorrect claims may lead to denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate patient records.
Mitigation Strategy
Only code E72.12 when there is a confirmed deficiency with clinical symptoms.
Impact
Lack of documentation for genetic testing necessity.
Mitigation Strategy
Ensure all tests are justified with clinical symptoms.
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 Deficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for MTHFR Deficiency
Use these documentation templates to ensure complete and accurate documentation for MTHFR Deficiency. These templates include all required elements for proper coding and billing.
Pregnancy with MTHFR Deficiency
Specialty: ObstetricsRequired Elements
- Mutation type and zygosity
- Clinical impact on pregnancy
- Treatment plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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