ICD-10 Code for Copper Deficiency After Gastric Bypass Surgery
The appropriate ICD-10 code for copper deficiency occurring after gastric bypass surgery is E61.0 (Copper deficiency), which should be coded alongside Z98.84 (Bariatric surgery status) to capture both the deficiency and its surgical etiology.
Primary Diagnosis Code
- E61.0 is the specific ICD-10 code for copper deficiency and should be listed as the primary diagnosis when copper deficiency is the reason for the encounter 1, 2, 3, 4
Essential Secondary Code
- Z98.84 (Bariatric surgery status) must be added as a secondary code to document the underlying cause and surgical history that predisposed the patient to this nutritional deficiency 2, 3, 4, 5
Additional Codes Based on Clinical Manifestations
If the copper deficiency has resulted in specific complications, add the following codes as clinically appropriate:
- D53.9 (Nutritional anemia, unspecified) or D64.9 (Anemia, unspecified) if anemia is present 2, 3, 4, 6
- D70.9 (Neutropenia, unspecified) if neutropenia or leukopenia has developed 4, 6
- D69.6 (Thrombocytopenia, unspecified) if thrombocytopenia is documented 1, 6
- G95.9 (Disease of spinal cord, unspecified) or G62.9 (Polyneuropathy, unspecified) if myeloneuropathy or peripheral neuropathy is present 1, 2, 3, 4
Clinical Context for Coding Accuracy
Copper deficiency after gastric bypass presents with distinctive features that support accurate diagnosis coding:
- Hematologic manifestations include anemia, neutropenia, leukopenia, thrombocytopenia, and bone marrow dysplasia that can mimic myelodysplastic syndrome 4, 6
- Neurologic manifestations include myeloneuropathy with posterior column involvement, peripheral neuropathy, ataxia, and gait abnormalities that may be irreversible if treatment is delayed 2, 3, 4, 5
- Copper deficiency is particularly common after Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD/DS) procedures due to malabsorption 1, 3, 4
Common Coding Pitfall to Avoid
- Do not use E83.0 (Disorders of copper metabolism), which is reserved for genetic disorders like Wilson's disease or Menkes disease, not acquired copper deficiency from malabsorption 1, 2
- Always include Z98.84 to establish the causal relationship between the bariatric surgery and the nutritional deficiency, as this affects treatment planning and monitoring requirements 1, 3
Documentation Requirements
Ensure medical documentation includes:
- Laboratory confirmation of low serum copper levels (typically <70 µg/dL) and low ceruloplasmin 2, 3, 4
- Type of bariatric procedure performed (RYGB, sleeve gastrectomy, BPD/DS) 1
- Time interval since surgery, as copper deficiency typically manifests months to years post-operatively 2, 4, 5
- Presence or absence of concurrent zinc supplementation, which can precipitate copper deficiency 1, 7, 2