2025 ICD-10-CM code E74
Other disorders of carbohydrate metabolism
Medical necessity is established by the presence of signs, symptoms, or laboratory findings consistent with a carbohydrate metabolism disorder.Diagnostic testing and treatment are medically necessary to confirm the diagnosis, manage symptoms, prevent complications, and improve the patient's quality of life.The specific medical necessity requirements may vary depending on the specific disorder and the payer's policies.
Diagnosis and treatment of carbohydrate metabolism disorders are typically overseen by specialists, often working in tertiary care centers.These specialists may include pediatricians, pediatric neurologists, biochemical geneticists, psychiatrists, and neurologists specializing in intellectual disability, neuromuscular diseases, or ataxia.
In simple words: This code refers to problems with how your body uses sugars and starches.These disorders can range from common ones like lactose intolerance to rarer genetic conditions affecting how your body processes sugars like fructose and galactose, or how it stores and uses glycogen (stored sugar). Symptoms can vary depending on the specific disorder, and can include things like low blood sugar, enlarged liver, muscle cramps, and developmental delays.
Other carbohydrate metabolism disorders refers to conditions that may be caused by the absence or deficiency, dysfunction, synthesis, or transport of carbohydrate (starch and sugar) compounds. The provider documents a type of carbohydrate metabolism disorder, such as glycogen storage disease (GSD), fructose metabolism disorder, galactose metabolism disorder, and other disorders of carbohydrate malabsorption, not represented by another category.
Example 1: A patient presents with recurrent episodes of hypoglycemia, lactic acidosis, and ketosis.After extensive testing, including genetic analysis, they are diagnosed with a disorder of gluconeogenesis, the process of making glucose from non-carbohydrate sources., An infant exhibits failure to thrive, hepatomegaly, and hypoglycemia.Enzyme assays and genetic tests confirm a diagnosis of Glycogen Storage Disease Type I (von Gierke disease)., A child experiences digestive problems, cataracts, and developmental delays after consuming milk-based products.Diagnostic tests reveal galactosemia, a disorder of galactose metabolism.
Documentation should specify the type of carbohydrate metabolism disorder, supporting clinical findings, results of diagnostic tests (e.g., enzyme assays, genetic tests, liver biopsies), and any associated complications.Detailed history, physical exam findings, and therapeutic interventions should also be documented.
** Excludes1: diabetes mellitus (E08-E13) hypoglycemia NOS (E16.2) increased secretion of glucagon (E16.3) mucopolysaccharidosis (E76.0-E76.3)
- Specialties:Endocrinology, Genetics, Pediatrics, Neurology, Gastroenterology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office, Independent Clinic