ICD-10 Diagnostic Codes for Eating Disorders and Associated Laboratory Tests
The primary ICD-10 diagnostic codes for eating disorders include F50.0 for anorexia nervosa, F50.2 for bulimia nervosa, and F50.8 for binge eating disorder, with specific laboratory tests recommended including complete blood count, comprehensive metabolic panel, and electrocardiogram for proper assessment and monitoring. 1
Primary ICD-10 Diagnostic Codes for Eating Disorders
- F50.0 - Anorexia Nervosa: Characterized by restriction of food intake leading to significantly low body weight, intense fear of weight gain, and body image distortion 2
- F50.1 - Atypical Anorexia Nervosa: Features of anorexia nervosa but not meeting all diagnostic criteria 1
- F50.2 - Bulimia Nervosa: Characterized by recurrent episodes of binge eating followed by compensatory behaviors 1
- F50.8 - Other Eating Disorders: Includes Binge Eating Disorder (characterized by recurrent episodes of binge eating without compensatory behaviors) 3
- F50.9 - Eating Disorder, Unspecified: Used when criteria for specific eating disorders are not fully met 1
- F50.82 - Avoidant/Restrictive Food Intake Disorder: Characterized by abnormal eating behaviors resulting in insufficient nutritional intake 1
Eating Disorder Subtypes
- F50.01 - Anorexia Nervosa, Restricting Type: Primary weight loss through dieting, fasting, or excessive exercise 2
- F50.02 - Anorexia Nervosa, Binge-eating/Purging Type: Regular engagement in binge eating and/or purging behaviors while maintaining significantly low body weight 2
Essential Laboratory Tests for Eating Disorders
Basic Laboratory Assessment
- Complete Blood Count (CBC): To assess for anemia, leukopenia, and thrombocytopenia 1
- Comprehensive Metabolic Panel: Including electrolytes, liver enzymes, and renal function tests 1
- Electrocardiogram (ECG): Particularly important for patients with restrictive eating disorders, severe purging behaviors, or those taking medications that prolong QTc intervals 1
Additional Testing Based on Clinical Presentation
- Thyroid Function Tests: To rule out thyroid disorders that may mimic eating disorder symptoms 4
- Serum Amylase: May be elevated in patients who purge frequently 4
- Reproductive Hormone Levels: To assess for disturbances in reproductive hormones (e.g., decreased estradiol in females) 4
- Bone Density Testing: For patients with prolonged malnutrition or amenorrhea 4
Clinical Assessment Components
- Anthropometric Measurements: Height, weight, BMI (or percent median BMI, BMI percentile, or BMI Z-score for children and adolescents) 1
- Vital Signs: Temperature, resting heart rate, blood pressure, orthostatic pulse, and orthostatic blood pressure 1
- Physical Examination: Assessment for signs of malnutrition or purging behaviors 1
Documentation Requirements
- Comprehensive Treatment Plan: Should incorporate medical, psychiatric, psychological, and nutritional expertise, commonly via a coordinated multidisciplinary team 1
- Eating Behavior Assessment: Documentation of frequency, intensity, or time spent on dietary restriction, binge eating, purging, exercise, and other compensatory behaviors 1
- Psychosocial Impairment: Assessment of impairment secondary to eating or body image concerns or behaviors 1
Common Pitfalls in Diagnosis and Coding
- Overlooking Eating Disorders in Males: Eating disorders affect both genders but may be underdiagnosed in males 3
- Weight Bias: Binge eating disorder can occur in individuals of all weight categories and should not be overlooked in those who are not underweight 3
- Failure to Assess Comorbidities: Eating disorders have high rates of psychiatric comorbidities (depression, anxiety) and medical complications that should be separately coded 4
- Inconsistent Laboratory Monitoring: Regular monitoring of laboratory values is essential, especially in severely ill patients 1
Remember that early identification and intervention are critical as eating disorders have high mortality rates and significant medical complications 3, 4.