Liver enzymes, elevated (liver function tests): Difference between revisions
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Ttenbergen (talk | contribs) m (update as per task April 19, 2022) |
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* Gamma-glutamyl transferase (GGT) | * Gamma-glutamyl transferase (GGT) | ||
=== vs [[Disorder of liver, NOS]] === | |||
*In general, coding abnormal laboratory findings is optional when the specific cause is known and coded. | |||
* | *In the absence of knowing the specific cause, the choice of using the code for abnormal lab test versus a nonspecific diagnosis code (e.g. [[Disorder of liver, NOS]]) should mainly be guided by whether or not the other coded diagnoses are present. | ||
* | **Example: COVID is associated with elevated LFTs in about 30% of cases. Thus if that is the only recognized reason for the elevated LFTs, then it makes most sense to code and link the COVID diagnosis and the abnormal labs together (instead of using the [[Disorder of liver, NOS]] code). | ||
{{ICD10 Guideline abnormal test}} | {{ICD10 Guideline abnormal test}} | ||
{{ICD10 Guideline Signs Symptoms Test Results not needed when cause known}} | {{ICD10 Guideline Signs Symptoms Test Results not needed when cause known}} | ||
Revision as of 15:14, 2022 May 4
| ICD10 Diagnosis | |
| Dx: | Liver enzymes, elevated (liver function tests) |
| ICD10 code: | R74.0 |
| Pre-ICD10 counterpart: | Nonalcoholic Liver Disease |
| Charlson/ALERT Scale: | none |
| APACHE Como Component: | none |
| APACHE Acute Component: | none |
| Start Date: | |
| Stop Date: | |
| External ICD10 Documentation | |
This diagnosis is a part of ICD10 collection.
Additional Info
Includes:
- Transaminases, LDH
- Alkaline phosphatase (ALP)
- Alanine transaminase (ALT)
- Aspartate transaminase (AST)
- Gamma-glutamyl transferase (GGT)
vs Disorder of liver, NOS
- In general, coding abnormal laboratory findings is optional when the specific cause is known and coded.
- In the absence of knowing the specific cause, the choice of using the code for abnormal lab test versus a nonspecific diagnosis code (e.g. Disorder of liver, NOS) should mainly be guided by whether or not the other coded diagnoses are present.
- Example: COVID is associated with elevated LFTs in about 30% of cases. Thus if that is the only recognized reason for the elevated LFTs, then it makes most sense to code and link the COVID diagnosis and the abnormal labs together (instead of using the Disorder of liver, NOS code).
Abnormal test
- This code identifies an abnormal test result, not a disorder.
- The preference is to code the cause of the abnormal test, if known.
- also coding this abnormal test, along with the cause is optional however, it is not necessary.
- When the DX is not known, code likely related other tests and signs and symptoms as Combined ICD10 codes; some likely ones might be listed in #Candidate Combined ICD10 codes.
Symptom/Sign/Test Result not needed when cause known
- This code identifies a symptom or a sign, or an abnormal test result, not a disorder.
- So, you should code the cause of the symptom/sign/abnormal test, if known -- and if you do so, then also coding and combining the symptom/sign/abnormal test result to that cause is generally optional, but is guided by the following guidelines.
- Here are guidelines for whether or not to ALSO code the symptom/sign/abnormal test when you DO code the underlying cause:
- If it is a subjective symptom (e.g. pain) then coding it is optional
- When it is a physical exam finding (e.g. abdominal tenderness) then coding it is generally optional
- An exception is when the symptom/sign/abnormal testis so severe that all by itself it mandates hospitalization and/or a procedure -- a good example is a patient who has Wegener's granulomatosis is admitted due with Hemoptysis. Since hemoptysis is a physical finding that fits this description of "severe" it should be coded, and combined with Wegener's.
- When it is an abnormal laboratory finding which in and of itself has relevance (e.g. hyperkalemia, hypoalbuminemia) then USUALLY code it
- You don't need to code the abnormal lab finding is when it is actually a major component of the underlying cause --- example is when a person presents with an acute MI, there is no need to code the abnormal troponin as Abnormal blood chemistry NOS
- The trickiest of these guidelines is for abnormal radiologic tests
- When the abnormal test is fully explained by the underlying diagnosis/diagnoses (e.g. pneumonia as cause of abnormal chest imaging, or a skull fracture with an intracranial hemorrhage both identified by an abnormal head CT) then coding the abnormal imaging result is optional
- But remember there are some rare things for which the abnormal imaging result IS part of coding the entity, for example we code retroperitoneal hemorrhage by the combination of Hemorrhage, NOS and Retroperitoneal area, diagnostic imaging, abnormal
- Sometimes there may be multiple symptom/sign/test result that might or might NOT be related to each other by virtue of having the same underlying cause. Since in the absence of KNOWING that cause, such assumptions may well be incorrect, do NOT combine them together if you are not certain they actually have the same underlying cause.
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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Alternate ICD10s to consider coding instead or in addition
Candidate Combined ICD10 codes
Related CCI Codes
Data Integrity Checks (automatic list)
none found
Related Articles
Show all ICD10 Subcategories