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v1.0.0
ICD-10 Guide
ICD-10 CodesE70.3

E70.3

Billable

Albinism

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E70.3 is a billable code used to indicate a diagnosis of albinism.

Key Diagnostic Point:

Albinism is a genetic condition characterized by a deficiency in melanin production, leading to a lack of pigmentation in the skin, hair, and eyes. This condition is primarily caused by mutations in genes responsible for the production of melanin, such as the TYR gene, which encodes the enzyme tyrosinase. Individuals with albinism often present with very light skin and hair, and they may experience vision problems due to abnormal development of the retina and optic nerve. The absence of melanin also increases the risk of skin cancers due to heightened sensitivity to ultraviolet (UV) light. Albinism can be classified into several types, including oculocutaneous albinism (OCA) and ocular albinism (OA), each with varying degrees of pigmentation and associated ocular issues. Diagnosis typically involves clinical evaluation, family history, and genetic testing to identify specific mutations. Management focuses on protecting the skin from sun exposure, addressing vision problems, and providing psychological support to affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among patients
  • Need for genetic testing to confirm diagnosis
  • Potential for associated conditions (e.g., skin cancer)
  • Differentiation from other hypopigmentation disorders

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to document associated conditions (e.g., skin cancer)
  • Misclassification with other hypopigmentation disorders
  • Lack of detailed family history

Specialty Focus

Medical Specialties

Genetics

Documentation Requirements

Detailed family history, genetic test results, and clinical findings.

Common Clinical Scenarios

Genetic counseling for families with a history of albinism, testing for carrier status.

Billing Considerations

Ensure accurate documentation of genetic mutations and inheritance patterns.

Dermatology

Documentation Requirements

Clinical examination findings, treatment plans for skin protection.

Common Clinical Scenarios

Management of skin lesions, counseling on sun protection.

Billing Considerations

Document any skin cancers or precancerous lesions associated with albinism.

Coding Guidelines

Inclusion Criteria

Use E70.3 When
  • Follow ICD
  • CM guidelines for coding genetic conditions
  • Include documentation of the specific type of albinism when applicable
  • Ensure that any associated conditions are also coded appropriately

Exclusion Criteria

Do NOT use E70.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81291CPT Code

Genetic testing for albinism

Clinical Scenario

Used when genetic confirmation of albinism is required.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Genetic counseling may be necessary following testing.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of albinism, improving the accuracy of data collection and reimbursement processes for genetic conditions.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of albinism, improving the accuracy of data collection and reimbursement processes for genetic conditions.

Reimbursement & Billing Impact

reimbursement processes for genetic conditions.

Resources

Clinical References

  • •
    National Organization for Albinism and Hypopigmentation

Coding & Billing References

  • •
    National Organization for Albinism and Hypopigmentation

Frequently Asked Questions

What is the primary cause of albinism?

Albinism is primarily caused by genetic mutations affecting melanin production, most commonly in the TYR gene.