ICD-10 Coding for Prealbumin Deficiency(E43, K74.60)
Complete ICD-10-CM coding and documentation guide for Prealbumin Deficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Prealbumin Deficiency
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E43 | Unspecified severe protein-calorie malnutrition | Use when severe malnutrition is confirmed by clinical signs and prealbumin levels. |
|
| K74.60 | Cirrhosis of liver, unspecified | Use when liver disease is confirmed and prealbumin levels support the diagnosis. |
|
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 low prealbumin
Essential facts and insights about Prealbumin Deficiency
Primary ICD-10-CM Codes for prealbumin
Decision Criteria
clinical Criteria
- Prealbumin <11 mg/dL with significant weight loss
Applicable To
- Severe malnutrition with prealbumin <11 mg/dL
Excludes
- Moderate malnutrition (E44.0)
Clinical Validation Requirements
- Prealbumin <11 mg/dL
- Significant weight loss (>10% over 3 months)
Code-Specific Risks
- Misclassification if prealbumin levels are not corroborated by clinical findings.
Coding Notes
- Ensure documentation supports the severity of malnutrition with both clinical and laboratory findings.
K74.60 - Cirrhosis of liver, unspecified
Use when liver disease is confirmed and prealbumin levels support the diagnosis.
Applicable To
- Liver disease with low prealbumin
Excludes
- Alcoholic liver disease (K70.0)
Clinical Validation Requirements
- Prealbumin <16 mg/dL
- Clinical signs of liver dysfunction
Coding Notes
Document liver function tests and clinical signs to support coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Other hypoalbuminemia
E88.09Differential 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 Prealbumin Deficiency to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E43.
Impact
Clinical: Inaccurate assessment of nutritional status., Regulatory: Non-compliance with coding standards., Financial: Potential for denied claims.
Mitigation Strategy
Always document weight loss percentage, Include BMI in assessments
Impact
Reimbursement: Incorrect coding can lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate representation of patient condition.
Mitigation Strategy
Code the underlying condition such as malnutrition or liver disease.
Impact
Risk of incorrect coding if prealbumin is used without supporting clinical evidence.
Mitigation Strategy
Ensure all malnutrition codes are supported by clinical documentation.
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 Prealbumin Deficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Prealbumin Deficiency
Use these documentation templates to ensure complete and accurate documentation for Prealbumin Deficiency. These templates include all required elements for proper coding and billing.
Severe Malnutrition Documentation
Specialty: NutritionRequired Elements
- Prealbumin level
- Weight loss
- BMI
- Clinical signs
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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