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| == Additional Info == | | == Additional Info == |
| * The parameters for coding hypercalcemia (using total serum calcium) is the following: | | * The criteria for coding this are: |
| ** Ca++ >= 3.3 | | ** Ca++ >= 3.3 |
| ** ionized Ca++ >=1.6 | | ** ionized Ca++ >=1.6 |
| | | |
| *Main signs and symptoms of hypercalcemia are: | | *Presence/absence of signs or symptoms are not part of the coding criterion, though they are: |
| **GI - anorexia, nausea\vomiting, constipation, abdominal pain, increased acid production (dyspepsia, PUD), pancreatitis | | **GI - anorexia, nausea\vomiting, constipation, abdominal pain, increased acid production (dyspepsia, PUD), pancreatitis |
| **Neuromuscular - weakness, proximal myopathy, decreased tone, decreased DTRs | | **Neuromuscular - weakness, proximal myopathy, decreased tone, decreased DTRs |
This diagnosis is a part of ICD10 collection.
- SMW
- 2019-01-01
- 2999-12-31
- E83.52
Additional Info
- The criteria for coding this are:
- Ca++ >= 3.3
- ionized Ca++ >=1.6
- Presence/absence of signs or symptoms are not part of the coding criterion, though they are:
- GI - anorexia, nausea\vomiting, constipation, abdominal pain, increased acid production (dyspepsia, PUD), pancreatitis
- Neuromuscular - weakness, proximal myopathy, decreased tone, decreased DTRs
- CNS - CNS depression ( lethargy, confusion * coma), ataxia, abnormal EEG, depression, psychosis
- Cardiovascular - hypertension, short QT interval, bradycardia, arrythmias
- Renal - nephrogenic D.I., calcium nephropathy (stones, nephrocalcinosis, azotemia)
- Miscellaneous - metastatic calcification
See https://ccmdb.kuality.ca/index.php?title=Hypocalcemia&curid=5880&diff=136294&oldid=125421
Serum corrected calcium is not reported. Instead if there is a concern for hyper/hypocalcemia an ionized calcium is now recommended.
Electrolyte disturbance
The paradigm for coding electrolyte disturbance diagnoses has 2 aspects, which could overlap:
- (1) Relatively extreme numerical thresholds for specific disturbances, to be coded without reference to presence or absence of symptoms. The threshold values are listed on the page for each of the specific ICD10 codes for electrolyte disturbances.
- (2) If a patient has symptomatic disturbance, the new rule is to code the disturbance(s) (e.g. Coma NOS, Rhabdomyolysis, Ventricular fibrillation), and link that diagnosis to Electrolyte disorder, NOS
Log of previous electrolyte coding criteria
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Reverse chronological changes:
- 2025-04-09
- change to current definitions
- retired Hypoalbuminemia, severe
- altered the names of all these entities to remove the words "severe" and/or "symptomatic"; and changed the serum phosphate disturbance from including both low and high values, to name them Hypophosphatemia and to only now include low values (since hyperphosphatemia is almost never a clinically important problem).
- 2025-02-27 - switched to just a single, more extreme numerical threshold irrespective of symptoms.
- 2019-04-09 - As decided 2019-03-06 we introduced clear criteria when these should be coded; these were set up as "double threshold" values -- i.e. more extreme numerical thresholds without symptoms attributable to the disturbance, and less extreme threshold in those with symptoms
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Repeated events
If this happens repeatedly during the same ward or unit stay, only code it the first time it happens, regardless of whether it is an Admit Diagnosis or Acquired Diagnosis, rather than each time it happens. See ICD10 codes only coded the first time for other diagnoses coded this way.
Example:
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- A person has a self-limited episode of A-fib. It goes away and then recurs. Only code the first one.
- A person has a self-limited episode of A-fib. It goes away but then he has an episode of V-tach. As this is a different diagnosis, both of these should be listed, but only code once each.
- Patient comes in with hypokalemia. It’s treated and remits, but the next day it recurs. Only code the first time.
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Alternate ICD10s to consider coding instead or in addition
Log
- 2025-02-27 (item 4) - Changed from Ca++ > 3.5 OR any Ca++ > 2.55 AND in the presence of signs or symptoms believed to be due to hypercalcemia OR any Ca++ > 2.55 with active treatment for hypercalcemia
- 2024-03-04 - SH/DSM sent out a memo that serum corrected calcium will no longer be reported. Instead if there is a concern for hyper/hypocalcemia an ionized calcium is now recommended.
- 2018-02-12 (item 2) - decided to use thresholds as before ICD10
Related CCI Codes
none found
Related Articles
Related articles:
|
- Hyperparathyroidism (← links)
- Other Metabolic problems (← links)
- Combined ICD10 codes (← links)
- Lip or mouth or tonsils or pharynx, primary malignancy (← links)
- Heart, primary malignancy (← links)
- Mediastinum, primary malignancy (← links)
- Nerves, peripheral or autonomic, primary malignancy (← links)
- Lymph nodes, metastatic malignancy to them (also code primary site) (← links)
- Lung, metastatic malignancy to it (also code primary site) (← links)
- Pleura, metastatic malignancy to it (also code primary site) (← links)
- Respiratory system NOS, metastatic malignancy to it (also code primary site) (← links)
- Peritoneum, metastatic malignancy to it (also code primary site) (← links)
- Liver or biliary system, metastatic malignancy to it (also code primary site) (← links)
- Gastrointestinal system NOS, metastatic malignancy to it (also code primary site) (← links)
- Urinary system NOS, metastatic malignancy to it (also code primary site) (← links)
- Brain or meninges, metastatic malignancy to it (also code primary site) (← links)
- Bone or bone marrow, metastatic malignancy to it (also code primary site) (← links)
- Adrenal gland, metastatic malignancy to it (also code primary site) (← links)
- Site NOS, metastatic malignancy to it (also code primary site) (← links)
- Multiple endocrine adenomatosis (multiple endocrine neoplasia syndrome, MEN) (← links)
- Hyposplenism (← links)
- Parathyroid disorder, NOS (← links)
- Disorder of mineral metabolism, NOS (← links)
- Electrolyte disorder, NOS (← links)
- Kidney or ureter, disorder NOS (← links)
- Polyuria (← links)
- Weight loss, abnormal (← links)
- Past history, cancer (any type), believed cured (← links)
- Past history, removal of breast (mastectomy) (← links)
- Past history, removal of all or part of lung (← links)
- Past history, removal of any part of digestive tract (← links)
- Past history, removal of kidney (nephrectomy, partial or total) (← links)
- Past history, removal of organ NOS (← links)
- Past history of radiation therapy (← links)
- Past history of chemotherapy for neoplastic disease (← links)
- ICD10 Diagnosis List (← links)
- ICD10 after original import (← links)
- APACHE Acute Dxs in ICD10 codes (← links)
- Pharmacotherapy, antineoplastic agent, whole body (← links)
- Pharmacotherapy, immunostimulant, whole body (← links)
- Pharmacotherapy, immunosuppressive, whole body (← links)
- ICD10 Category (← links)
- Past history of Chimeric Antigen Receptor T-cell Immunotherapy (CAR-T) (← links)
- ICD10 Guideline for coding altered mental status (← links)
- CCMDB.accdb Change Log 2025 (← links)
- Task Team Meeting - Rolling Agenda and Minutes 2025 (← links)
- Template:ICD10 Guideline Combined dx metastasis primary (← links)
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