ICD-10 Coding for Protein Deficiency(D53.0, D68.51, E43)
Complete ICD-10-CM coding and documentation guide for Protein Deficiency. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Protein Deficiency
D50-D53Primary Range
Nutritional anemias
Includes anemia due to protein deficiency, such as D53.0 for protein deficiency anemia.
Coagulation defects
Includes coagulation disorders related to protein deficiencies, such as D68.51 for activated protein C resistance.
Malnutrition
Covers various forms of malnutrition, including severe protein-calorie malnutrition coded as E43.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| D53.0 | Protein deficiency anemia | Use when anemia is directly attributed to protein deficiency. |
|
| D68.51 | Activated protein C resistance | Use when genetic testing confirms Factor V Leiden mutation. |
|
| E43 | Unspecified severe protein-calorie malnutrition | Use when severe malnutrition is documented per ASPEN criteria. |
|
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 protein deficiency anemia
Essential facts and insights about Protein Deficiency
Primary ICD-10-CM Codes for protein deficiency
Decision Criteria
clinical Criteria
- Presence of hypoproteinemia and anemia
documentation Criteria
- Detailed note on protein deficiency causing anemia
Applicable To
- Hypoproteinemia with anemia
Clinical Validation Requirements
- Hypoproteinemia
- Anemia with Hgb <13 g/dL for men, <12 g/dL for women
- Low prealbumin <15 mg/dL
Code-Specific Risks
- Misclassification with other types of anemia
- Lack of documentation for hypoproteinemia
Coding Notes
- Ensure documentation specifies protein deficiency as the cause of anemia.
D68.51 - Activated protein C resistance
Use when genetic testing confirms Factor V Leiden mutation.
Applicable To
- Factor V Leiden mutation
Excludes
- Protein C deficiency (D68.52)
- Protein S deficiency (D68.53)
Clinical Validation Requirements
- Genetic confirmation of Factor V Leiden mutation
- APC resistance ratio >2.0
Coding Notes
Ensure genetic testing results are documented.
E43 - Unspecified severe protein-calorie malnutrition
Use when severe malnutrition is documented per ASPEN criteria.
Applicable To
- Severe malnutrition
Excludes
- Mild protein-calorie malnutrition (E44.0)
- Moderate protein-calorie malnutrition (E44.1)
Clinical Validation Requirements
- ASPEN criteria: >10% weight loss, BMI <18.5, reduced grip strength
Coding Notes
Ensure ASPEN criteria are documented in the medical record.
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.
Iron deficiency anemia
D50.9Protein C deficiency
D68.52Protein S deficiency
D68.53Mild protein-calorie malnutrition
E44.0Moderate protein-calorie malnutrition
E44.1Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Protein Deficiency to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code D53.0.
Impact
Clinical: Inaccurate assessment of malnutrition severity, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Ensure ASPEN criteria are documented, Conduct thorough nutritional assessments
Impact
Clinical: Misdiagnosis of coagulation disorders, Regulatory: Non-compliance with coding guidelines, Financial: Incorrect DRG assignment
Mitigation Strategy
Verify genetic testing is completed, Document test results in the medical record
Impact
Reimbursement: Potential denial of claims, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate representation of patient condition
Mitigation Strategy
Ensure documentation includes ≥2 ASPEN criteria.
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Coding inaccuracies, Data Quality: Misleading patient records
Mitigation Strategy
Verify genetic testing results for APC resistance.
Impact
High denial rates for E43 due to lack of ASPEN criteria documentation.
Mitigation Strategy
Ensure documentation includes ≥2 ASPEN criteria.
Impact
Incorrect coding of D68.51 without genetic confirmation.
Mitigation Strategy
Verify genetic testing results are documented.
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 Protein Deficiency, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Protein Deficiency
Use these documentation templates to ensure complete and accurate documentation for Protein Deficiency. These templates include all required elements for proper coding and billing.
Severe Malnutrition Assessment
Specialty: NutritionRequired Elements
- Weight loss percentage
- BMI
- Muscle mass evaluation
- Nutritional intake
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Coagulation Disorder Documentation
Specialty: HematologyRequired Elements
- Genetic test results
- Family history
- APC resistance ratio
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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