ICD-10 Coding for High Bilirubin(E80.6, P59.9)
Complete ICD-10-CM coding and documentation guide for High Bilirubin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Bilirubin
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E80.6 | Bilirubin metabolism disorders | Use for confirmed metabolic disorders affecting bilirubin metabolism. |
|
| P59.9 | Neonatal jaundice, unspecified | Use for newborns with jaundice where specific cause is not identified. |
|
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 high bilirubin
Essential facts and insights about High Bilirubin
Primary ICD-10-CM Codes for high bilirubin
Decision Criteria
clinical Criteria
- Presence of genetic mutation affecting bilirubin metabolism.
Applicable To
- Gilbert's syndrome
Excludes
- Neonatal jaundice (P59.-)
Clinical Validation Requirements
- Direct bilirubin >20% of total
- Genetic testing confirming UGT1A1 mutation
Code-Specific Risks
- Misclassification if genetic testing is not documented.
Coding Notes
- Ensure genetic testing results are documented to support E80.6.
P59.9 - Neonatal jaundice, unspecified
Use for newborns with jaundice where specific cause is not identified.
Applicable To
- Neonatal jaundice NOS
Excludes
- Breast milk jaundice (P59.3)
Clinical Validation Requirements
- TcB ≥95th percentile
- Negative Coombs, normal G6PD, no hemolysis
Coding Notes
Ensure neonatal age is documented to support use of P59.9.
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 Bilirubin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E80.6.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with coding standards., Financial: Potential for claim denials.
Mitigation Strategy
Ensure genetic test results are included in the medical record., Verify documentation before coding.
Impact
Reimbursement: May lead to denials if cause is not specified., Compliance: Non-compliance with coding guidelines., Data Quality: Reduces accuracy of clinical data.
Mitigation Strategy
Ensure workup is documented and specify cause if known.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Document all clinical findings and specify the cause when possible.
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 Bilirubin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Bilirubin
Use these documentation templates to ensure complete and accurate documentation for High Bilirubin. These templates include all required elements for proper coding and billing.
Neonatal jaundice management
Specialty: PediatricsRequired Elements
- Bilirubin levels
- Feeding method
- Phototherapy details
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
Need help with ICD-10 coding for High Bilirubin? Ask your questions below.