ICD-10 Coding for Lactic Acidosis(E87.21, E87.20)
Complete ICD-10-CM coding and documentation guide for Lactic Acidosis. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Lactic Acidosis
E87.2-E87.29Primary Range
Disorders of acid-base balance
This range includes codes for various types of acidosis, including lactic acidosis, which is the primary condition of interest.
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 documentation specifies acute lactic acidosis with supporting lab values. |
|
| E87.20 | Unspecified acidosis | Use when documentation lacks specificity or lab values do not confirm acute acidosis. |
|
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 lactic acidosis
Essential facts and insights about Lactic Acidosis
Primary ICD-10-CM Codes for lactic acidosis
Decision Criteria
clinical Criteria
- Presence of acute symptoms and lab values indicating acidosis
Applicable To
- Acute lactic acidosis
Excludes
- Chronic metabolic acidosis
Clinical Validation Requirements
- pH <7.35
- Lactate ≥5 mmol/L
Code-Specific Risks
- Incorrectly coding as chronic or unspecified acidosis
Coding Notes
- Ensure documentation explicitly states 'acute lactic acidosis' with lab confirmation.
E87.20 - Unspecified acidosis
Use when documentation lacks specificity or lab values do not confirm acute acidosis.
Applicable To
- Acidosis NOS
Excludes
- Specific types of acidosis like lactic or ketoacidosis
Clinical Validation Requirements
- Lactate elevated but pH ≥7.35
Coding Notes
Use only when documentation is vague or lab values are non-specific.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Adverse effect of metformin
T45.1X5ADifferential 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 Lactic 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: Misdiagnosis or inappropriate treatment plans., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement.
Mitigation Strategy
Ensure lab results are included in documentation, Educate staff on documentation standards
Impact
Reimbursement: Incorrect coding may lead to improper DRG assignment and reimbursement., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E87.21 for lactic acidosis and E10.10 for DKA with appropriate clinical indicators.
Impact
Missing or incorrect lab values can lead to audit flags.
Mitigation Strategy
Implement checks to ensure lab values 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 Lactic Acidosis, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Lactic Acidosis
Use these documentation templates to ensure complete and accurate documentation for Lactic Acidosis. These templates include all required elements for proper coding and billing.
Sepsis with lactic acidosis
Specialty: Emergency MedicineRequired Elements
- Diagnostic statement
- Lab values
- Etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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