Hypocalcemia

ICD10 Diagnosis
Dx:	Hypocalcemia
ICD10 code:	E83.51
Pre-ICD10 counterpart:	Hypocalcemia Ca Less Than 1.8
Charlson/ALERT Scale:	none
APACHE Como Component:	none
APACHE Acute Component:	2019-0: Metabolic/Renal NOS, 2019-0: Renal/Metabolic NOS
Start Date:
Stop Date:
External ICD10 Documentation	ICD-10 CM Wikipedia ICD-10 Wikipedia WHO ICD10 documentation ICD10data.com

This diagnosis is a part of ICD10 collection.

• SMW
  • 2019-01-01
  • 2999-12-31
  • E83.51

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Additional Info

Thresholds for pts with regular albumin levels

• The criteria for coding this is are either:
  • Ca++ <= 1.8 -- but as below, this is only reliable for those with albumin >= 3.0
  • ionized Ca++ <=0.8

Thresholds for pts with hypoalbuminemia

• For patients with substantial hypoalbuminemia using total calcium to define hypocalcemia is a problem.
• It's actually the ionized serum calcium that's relevant and causes symptoms when high or low -- AND the usual range for total calcium is altered (downwards) in patients with low serum albumin. So you can have a completely normal ionized calcium with a very low total calcium if the albumin is significantly low. Furthermore, the old "correction" of total calcium for measured albumin does not work well. Thus, to identify truly low circulating calcium in the presence of more than trivial hypoalbuminemia, it's necessary to use measurement of ionized calcium, using the threshold (as above) of ionized Ca++ <=0.8

• Presence/absence of signs or symptoms are not part of the coding criterion, though they are:
  • GI - nausea\vomiting, abdominal pain
  • Neuromuscular - paresthesias (esp. acral, perioral), muscle cramps\spasms, hyperreflexia, tetany, weakness, fatigue, seizures, extrapyramidal movement disorders, abnormal EEG
  • cardiovascular - long QT interval, hypotension (if acute), arrythmias
  • Miscellaneous - secondary hypoparathyroidism

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

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 2019-01-01 beginning of ICD10 collection based diagnostic coding of electrolyte disturbances including Hypoalbuminemia, severe

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:

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.

Alternate ICD10s to consider coding instead or in addition

• Tetany
• Disorder of mineral metabolism, NOS
• Electrolyte disorder, NOS
• Hyperparathyroidism
• Parathyroid disorder, NOS
• Cushing's syndrome, NOS
• Vitamin D deficiency

Candidate Combined ICD10 codes

Related CCI Codes

Data Integrity Checks (automatic list)

none found

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ICD10 Categories: ANCA-associated Vasculitis (AAV), Abdominal trauma, Abortion, Acute intoxication, Addiction, Adrenal Insufficiency, Adverse effect, Alcohol related, Allergy, Anemia, Anesthetic related, Aneurysm, Antibiotic resistance, Antidepressant related, Aortic Aneurysm, Arrhythmia, Arterial thromboembolism, Asthma, Atherosclerosis, Awaiting/delayed transfer, Bacteria, Benign neoplasm, Breast disease, Burn, COVID, Cannabis related, Cardiac septum problem, Cardiovascular, Cerebral Hemorrhage/Stroke, Chemical burn, Chronic kidney disease, Cirrhosis, Cocaine related, Decubitus ulcer, Delirium, Dementia, Diabetes, Diagnosis implying death, Double duty pathogen, ENT, Electrolyte disturbance, Encephalitis, Encephalopathy, Endocrine disorder, Endocrine neoplasm, Exposure, Eye, Female genital neoplasm, Fistula, Fracture, Fungus, GI ulcer, Gastroenteritis, Gastrointestinal, Gastrointestinal neoplasm, Hallucinogen related, Has one, Head trauma, Head trauma (old), Healthcare contact, Heart valve disease, Heme/immunology, Heme/immunology neoplasm, Hemophilia, Hemorrhage, Hepatitis, Hereditary/congenital, Hernia, Hypertension, Hypotension, Iatrogenic, Iatrogenic infection, Iatrogenic mechanism, Imaging, Infection requiring pathogen, Infection with implied pathogen, Infectious disease, Inflammatory Bowel Disease, Influenza, Inhalation, Intra-abdominal infection, Ischemia, Ischemic gut, Ischemic heart disease, Joint/ligament trauma, Leukemia, Liver disease, Liver failure, Lower limb trauma, Lower respiratory tract infection, Lymphoma, Male genital neoplasm, Mechanism, Meningitis, Metabolic/nutrition, Metastasis, Misc, Muscle problem, Muscles/tendon trauma, Musculoskeletal/soft tissue... further results