ICD-10 Coding for Cachexia(R64, E88.A)
Complete ICD-10-CM coding and documentation guide for Cachexia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Cachexia
R64Primary Range
Cachexia
This range is used for cachexia when the underlying condition is not specified.
Cachexia in diseases classified elsewhere
This range is used when cachexia is due to a specified underlying condition.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R64 | Cachexia | Use when cachexia is documented without a specified underlying condition. |
|
| E88.A | Cachexia in diseases classified elsewhere | Use when cachexia is documented as secondary to a specific condition. |
|
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 cachexia
Essential facts and insights about Cachexia
Primary ICD-10-CM Codes for cachexia
Decision Criteria
clinical Criteria
- Documented weight loss ≥5% with muscle wasting
coding Criteria
- No specific underlying condition documented
documentation Criteria
- Excludes other causes like hyperthyroidism
Applicable To
- Wasting syndrome
Clinical Validation Requirements
- Weight loss ≥5% over 6 months
- Muscle wasting on physical exam
- CRP >5 mg/dL or albumin <3.0 g/dL
Code-Specific Risks
- Confusion with malnutrition codes
- Incorrect sequencing with underlying conditions
Coding Notes
- Ensure documentation specifies weight loss percentage and muscle wasting.
E88.A - Cachexia in diseases classified elsewhere
Use when cachexia is documented as secondary to a specific condition.
Applicable To
- Cachexia due to cancer
- Cachexia due to chronic disease
Clinical Validation Requirements
- Explicit documentation linking cachexia to an underlying condition
Coding Notes
Ensure linkage to the underlying condition is documented.
Differential 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 Cachexia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R64.
Impact
Clinical: Inaccurate representation of patient's condition., Regulatory: Potential for coding audits and denials., Financial: May affect reimbursement rates.
Mitigation Strategy
Ensure clear documentation linking cachexia to underlying conditions., Use templates to guide documentation.
Impact
Reimbursement: Incorrect coding may affect DRG assignment and reimbursement., Compliance: May lead to coding errors and compliance issues., Data Quality: Affects the accuracy of clinical data.
Mitigation Strategy
Ensure both conditions are documented separately if present.
Impact
Lack of specific weight loss documentation can lead to audit issues.
Mitigation Strategy
Implement standardized templates for documenting weight loss.
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 Cachexia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Cachexia
Use these documentation templates to ensure complete and accurate documentation for Cachexia. These templates include all required elements for proper coding and billing.
Oncology patient with cachexia
Specialty: OncologyRequired Elements
- Weight history
- Nutrition impact symptoms
- Physical exam findings
- Exclusion of other causes
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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