From the Guidelines
The ICD-10 code for metabolic acidosis due to a low bicarbonate level is E87.4, which specifically represents "Acidosis, metabolic". This code is used to indicate metabolic acidosis, a condition characterized by an excess of acid in the body fluids or a deficiency of bicarbonate, as discussed in the context of chronic renal failure and metabolic disorders 1. When documenting this condition, healthcare providers should ensure they include any underlying causes of the low bicarbonate level if known, as additional codes may be needed to fully capture the patient's condition. Metabolic acidosis, as noted in the guidelines for nutrition in chronic renal failure, can lead to increased oxidation of branched-chain amino acids, protein degradation, and decreased albumin synthesis, highlighting the importance of monitoring and correcting serum bicarbonate levels 1. The management of metabolic acidosis involves normalization of the predialysis or stabilized serum bicarbonate concentration, which can be achieved through higher dialysate bicarbonate concentrations or oral supplementation with bicarbonate salts, aiming to maintain serum bicarbonate at or above 22 mmol/L 1.
Key considerations in the management and coding of metabolic acidosis include:
- Regular monitoring of serum bicarbonate levels
- Correction of metabolic acidemia through dialysate adjustments or oral bicarbonate supplementation
- Addressing underlying causes of low bicarbonate levels
- Potential for increased hospital stays if serum bicarbonate levels are not adequately managed, as observed in long-term studies of patients undergoing continuous peritoneal dialysis (CPD) 1.
Given the clinical implications of metabolic acidosis, including its effects on morbidity, mortality, and quality of life, accurate coding and management are crucial for patient care and outcomes.
From the Research
ICD Code for Low Bicarb Level
The ICD code for metabolic acidosis due to a low bicarbonate level can be found under the category of metabolic disorders.
- The specific ICD-10 code for metabolic acidosis is E87.4 2.
- This code is used to indicate a condition where there is a primary reduction in serum bicarbonate concentration, leading to a decrease in blood pH.
- Metabolic acidosis can be caused by various factors, including the overproduction of organic acids, bicarbonate wasting, or impaired renal acidification 2.
- The diagnosis of metabolic acidosis involves calculating the serum anion gap, which can help classify the disorder into categories of normal (hyperchloremic) anion gap or elevated anion gap 2.
- It is essential to note that the ICD code for metabolic acidosis may vary depending on the underlying cause and the specific clinical context.
Related Conditions
- Diabetic ketoacidosis, a severe metabolic derangement characterized by dehydration, loss of electrolytes, hyperglycemia, hyperketonemia, acidosis, and progressive loss of consciousness, can be coded as E11.1 3.
- Lactic acidosis, a condition characterized by the accumulation of lactic acid in the blood, can be coded as E87.4 2.
- Hyperchloremic acidosis, a condition characterized by an increase in chloride ions in the blood, can be coded as E87.4 2.
Clinical Context
- Metabolic acidosis can have significant adverse effects, including decreased cardiac output, arterial dilatation with hypotension, altered oxygen delivery, decreased ATP production, predisposition to arrhythmias, and impairment of the immune response 2.
- The treatment of metabolic acidosis depends on the underlying cause and may involve the administration of base, insulin, or other medications to correct the acid-base imbalance 3, 2.