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v1.0.0
ICD-10 Guide
ICD-10 CodesD72.119

D72.119

Billable

Hypereosinophilic syndrome [HES], unspecified

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

Code Description

ICD-10 D72.119 is a billable code used to indicate a diagnosis of hypereosinophilic syndrome [hes], unspecified.

Key Diagnostic Point:

Hypereosinophilic syndrome (HES) is characterized by an elevated eosinophil count in the blood, typically exceeding 1,500 eosinophils per microliter, and is associated with various clinical manifestations. The condition can lead to significant organ damage due to eosinophil infiltration and the release of inflammatory mediators. Patients may present with symptoms such as fever, fatigue, weight loss, and respiratory issues, including asthma-like symptoms. HES can be primary (idiopathic) or secondary to other conditions, including infections, malignancies, or autoimmune disorders. The diagnosis is often confirmed through blood tests showing eosinophilia and may require bone marrow biopsy to rule out other hematological disorders. Management typically involves corticosteroids and other immunosuppressive therapies to control eosinophil levels and mitigate organ damage. Due to its complex nature and potential overlap with other white blood cell disorders, accurate coding is essential for appropriate treatment and reimbursement.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary HES
  • Potential overlap with other eosinophilic disorders
  • Need for comprehensive lab results to confirm diagnosis
  • Documentation of associated symptoms and organ involvement

Audit Risk Factors

  • Inadequate documentation of eosinophil counts
  • Failure to specify primary vs. secondary HES
  • Lack of supporting clinical evidence for diagnosis
  • Insufficient detail on organ involvement

Specialty Focus

Medical Specialties

Hematology

Documentation Requirements

Complete blood count (CBC) results, bone marrow biopsy reports, and clinical notes detailing symptoms and treatment response.

Common Clinical Scenarios

Patients presenting with unexplained eosinophilia, respiratory symptoms, or organ dysfunction.

Billing Considerations

Ensure clear documentation of eosinophil counts and any associated conditions to support the diagnosis.

Immunology

Documentation Requirements

History of allergic reactions, autoimmune disorders, and detailed immunological assessments.

Common Clinical Scenarios

Patients with recurrent infections or autoimmune symptoms alongside eosinophilia.

Billing Considerations

Document any immunodeficiencies or related conditions that may contribute to HES.

Coding Guidelines

Inclusion Criteria

Use D72.119 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of eosinophil counts and associated symptoms
  • Include any relevant lab results and clinical findings to support the diagnosis of HES

Exclusion Criteria

Do NOT use D72.119 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Complete Blood Count (CBC) with Differential

Clinical Scenario

Used to confirm eosinophilia in suspected HES cases.

Documentation Requirements

Document the specific eosinophil count and any associated symptoms.

Specialty Considerations

Hematology specialists should ensure comprehensive lab results are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of hypereosinophilic syndrome, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better understanding the condition's prevalence and management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hypereosinophilic syndrome, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better understanding the condition's prevalence and management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hypereosinophilic syndrome, improving the accuracy of diagnoses and treatment tracking. This specificity aids in better understanding the condition's prevalence and management.

Resources

Clinical References

  • •
    Hypereosinophilic Syndrome Overview

Coding & Billing References

  • •
    Hypereosinophilic Syndrome Overview

Frequently Asked Questions

What is the primary cause of hypereosinophilic syndrome?

The primary cause of hypereosinophilic syndrome is often idiopathic, meaning the exact cause is unknown. However, it can also be secondary to infections, malignancies, or autoimmune diseases.