ICD-10 Coding for High Anion Gap Metabolic Acidosis(E87.21, E87.22)
Complete ICD-10-CM coding and documentation guide for High Anion Gap Metabolic Acidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Anion Gap Metabolic Acidosis
E87.2-E87.22Primary Range
Metabolic acidosis codes including unspecified, acute, and chronic forms
This range includes the primary codes for documenting high anion gap metabolic acidosis.
Septic shock with lactic acidosis
Used when HAGMA is part of septic shock, where lactic acidosis is integral.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E87.21 | Acute metabolic acidosis | Use when acute high anion gap metabolic acidosis is documented and not integral to another condition. |
|
| E87.22 | Chronic metabolic acidosis | Use for chronic conditions like ESRD causing persistent high anion gap. |
|
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 HAGMA
Essential facts and insights about High Anion Gap Metabolic Acidosis
Primary ICD-10-CM Codes for hagma
Decision Criteria
clinical Criteria
- Presence of acute high anion gap with supporting lab values.
Applicable To
- Acute high anion gap metabolic acidosis
Excludes
- Diabetic ketoacidosis (E10.10)
Clinical Validation Requirements
- Anion gap >12
- pH <7.35
- HCO3- <22 mEq/L
Code-Specific Risks
- Incorrectly coding when part of another condition like septic shock.
Coding Notes
- Ensure documentation specifies 'acute' and the underlying cause.
E87.22 - Chronic metabolic acidosis
Use for chronic conditions like ESRD causing persistent high anion gap.
Applicable To
- Chronic high anion gap metabolic acidosis
Excludes
- Acute metabolic acidosis (E87.21)
Clinical Validation Requirements
- Persistent anion gap >12
- Chronic low bicarbonate levels
Coding Notes
Clarify chronicity in documentation.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting High Anion Gap Metabolic Acidosis to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E87.21.
Impact
Clinical: Lack of specificity in treatment plans., Regulatory: Potential audit flags for unspecified coding., Financial: May affect reimbursement rates.
Mitigation Strategy
Clarify type of acidosis in documentation., Use specific codes when possible.
Impact
Reimbursement: Incorrect DRG assignment affecting reimbursement., Compliance: Non-compliance with ICD-10 guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use R65.21 for septic shock as it includes lactic acidosis.
Impact
Failure to code underlying condition first.
Mitigation Strategy
Educate coders on sequencing rules.
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 High Anion Gap Metabolic Acidosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Anion Gap Metabolic Acidosis
Use these documentation templates to ensure complete and accurate documentation for High Anion Gap Metabolic Acidosis. These templates include all required elements for proper coding and billing.
Acute HAGMA due to toxic ingestion
Specialty: Emergency MedicineRequired Elements
- Anion gap calculation
- ABG results
- Underlying cause
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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