ICD-10 Coding for Gilbert's Disease(E80.4)
Complete ICD-10-CM coding and documentation guide for Gilbert's Disease. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Gilbert's Disease
E80.0-E80.9Primary Range
Disorders of porphyrin and bilirubin metabolism
This range includes conditions related to bilirubin metabolism, including Gilbert syndrome.
Key Information: ICD-10 code for Gilbert's disease
Essential facts and insights about Gilbert's Disease
Primary ICD-10-CM Code for gilbert's disease
Decision Criteria
clinical Criteria
- Unconjugated hyperbilirubinemia with normal liver function tests
documentation Criteria
- Documented absence of hemolysis
Applicable To
- Gilbert's syndrome
- Inherited disorder of bilirubin metabolism
Clinical Validation Requirements
- Unconjugated hyperbilirubinemia <6 mg/dL
- Normal liver function tests (ALT/AST <40 U/L)
- Absence of hemolysis (normal CBC, LDH, haptoglobin)
Code-Specific Risks
- Confusing with other hyperbilirubinemias
- Not documenting absence of hemolysis
Coding Notes
- Always sequence E80.4 first when Gilbert syndrome is the primary reason for the encounter.
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.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Gilbert's Disease to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E80.4.
Impact
Clinical: May lead to misdiagnosis., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always specify if bilirubin is unconjugated.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Always code E80.4 first if confirmed.
Impact
Coding E80.4 without documented unconjugated hyperbilirubinemia.
Mitigation Strategy
Ensure all lab results are documented and meet criteria.
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 Gilbert's Disease, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Gilbert's Disease
Use these documentation templates to ensure complete and accurate documentation for Gilbert's Disease. These templates include all required elements for proper coding and billing.
Emergency Department Note
Specialty: Emergency MedicineRequired Elements
- Patient history
- Physical exam findings
- Laboratory results
- Diagnosis
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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