What is Hypochloremia and How to Code the ICD 10 Code for Hypochloremia?
Hypochloremia is a condition where the blood chloride level is abnormally low. Chloride is an electrolyte that helps maintain the acid-base balance and fluid balance in the body. Hypochloremia can be caused by various factors, such as vomiting, diarrhea, kidney disease, diuretics, metabolic alkalosis, or excessive sweating.
Hypochloremia can cause symptoms such as weakness, muscle cramps, confusion, dehydration, or low blood pressure. In severe cases, it can lead to coma or death. Hypochloremia can be diagnosed by a blood test that measures the serum chloride level. The normal range of chloride in the blood is 96 to 106 milliequivalents per liter (mEq/L).
How to Code Hypochloremia in ICD-10-CM?
To code hypochloremia in ICD-10-CM, you need to identify the underlying cause and the severity of the condition. Depending on these factors, you can use one of the following codes:
– E87.8 Other disorders of electrolyte and fluid balance, not elsewhere classified. This code can be used for hypochloremia due to any cause other than those listed below. It includes conditions such as electrolyte imbalance NOS, hyperchloremia, or hypochloremia.
– E87.1 Hypo-osmolality and hyponatremia. This code can be used for hypochloremia due to low sodium levels in the blood. Sodium and chloride are often linked together in body fluids, so a decrease in sodium can also cause a decrease in chloride.
– P74.422 Hypochloremia of a newborn. This code can be used for hypochloremia which occurs in a newborn baby within 28 days of birth. It is a specific code that should be recorded on the newborn record.
– E88.89 Other specified metabolic disorders. This code can be used for hypochloremia due to a deficiency of dihydropyrimidine dehydrogenase (DPD), an enzyme that metabolizes certain drugs and organic acids.
When coding hypochloremia, you should also code any associated conditions or complications that affect the patient’s care or treatment. For example, if the patient has hypochloremia due to vomiting, you should also code R11.10 Vomiting, unspecified as an additional diagnosis.
FAQs
What are the causes of hypochloremia?
Hypochloremia can be caused by various factors that result in a loss of chloride from the body or a shift of chloride from the blood to the cells. Some common causes are:
– Vomiting or diarrhea that leads to a loss of gastric fluids that contain chloride
– Kidney disease that affects the reabsorption of chloride by the kidneys
– Diuretics that increase the excretion of chloride by the kidneys
– Metabolic alkalosis that causes a shift of chloride from the blood to the cells to maintain the acid-base balance
– Excessive sweating that leads to a loss of chloride through the skin
– Certain drugs or toxins that interfere with the metabolism of chloride
– Low sodium intake or high water intake that dilutes the blood chloride level
What are the symptoms of hypochloremia?
Hypochloremia can cause symptoms that are related to the disturbance of the acid-base balance and fluid balance in the body. Some common symptoms are:
– Weakness or fatigue
– Muscle cramps or spasms
– Confusion or irritability
– Dehydration or thirst
– Low blood pressure or shock
– Seizures or coma
How is hypochloremia diagnosed?
Hypochloremia can be diagnosed by a blood test that measures the serum chloride level. The normal range of chloride in the blood is 96 to 106 milliequivalents per liter (mEq/L). A level below 96 mEq/L indicates hypochloremia.
The blood test may also measure other electrolytes, such as sodium, potassium, bicarbonate, and calcium, to determine the cause and severity of hypochloremia. The blood test may also measure the blood pH and the blood osmolality to assess the acid-base balance and fluid balance in the body.
How is hypochloremia treated?
Hypochloremia is treated by correcting the underlying cause and restoring the normal chloride level in the blood. The treatment may include:
– Oral or intravenous rehydration with fluids that contain chloride and other electrolytes
– Discontinuation or adjustment of diuretics or other drugs that cause hypochloremia
– Treatment of kidney disease or metabolic alkalosis that cause hypochloremia
– Dietary modification to increase sodium and chloride intake or reduce water intake
– Monitoring of vital signs and electrolyte levels to prevent complications
Hypochloremia is a serious condition that requires prompt diagnosis and treatment. By using the correct ICD-10-CM code, you can help ensure accurate documentation and reimbursement for your services.
References
(1) 2023 ICD-10-CM Diagnosis Code E87.8 – The Web’s Free 2023 ICD-10-CM/PCS ….
(2) ICD-10-CM Code for Hypochloremia of newborn P74.422 – AAPC.
(3) P74.422 – ICD-10 Code for Hypochloremia of newborn – Billable.