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v1.0.0
ICD-10 Guide
ICD-10 CodesD81.39

D81.39

Billable

Other adenosine deaminase deficiency

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

Code Description

ICD-10 D81.39 is a billable code used to indicate a diagnosis of other adenosine deaminase deficiency.

Key Diagnostic Point:

Adenosine deaminase deficiency (ADA deficiency) is a rare inherited disorder that affects the immune system, leading to severe combined immunodeficiency (SCID). This condition is caused by mutations in the ADA gene, which is responsible for the breakdown of adenosine, a nucleoside that can be toxic at high levels. In individuals with ADA deficiency, the accumulation of toxic metabolites leads to lymphocyte apoptosis, resulting in a profound deficiency of T and B lymphocytes. Clinically, patients may present with recurrent infections, failure to thrive, and other complications associated with immunodeficiency. Diagnosis is typically confirmed through enzyme activity assays and genetic testing. Management may include enzyme replacement therapy, hematopoietic stem cell transplantation, and supportive care to prevent infections. The condition can lead to significant morbidity and mortality if not diagnosed and treated early.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic disorders and their implications.
  • Differentiation from other immunodeficiencies can be challenging.
  • Documentation must specify the type of deficiency and its severity.
  • Potential for co-morbid conditions complicating the clinical picture.

Audit Risk Factors

  • Inadequate documentation of genetic testing results.
  • Failure to specify the severity of the deficiency.
  • Misclassification of the condition as a more common immunodeficiency.
  • Lack of supporting clinical evidence for the diagnosis.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of recurrent infections, growth parameters, and family history.

Common Clinical Scenarios

Infants presenting with failure to thrive and recurrent infections.

Billing Considerations

Documentation should include immunization status and any preventive measures taken.

Hematology

Documentation Requirements

Laboratory results showing lymphocyte counts and enzyme activity levels.

Common Clinical Scenarios

Patients undergoing evaluation for immunodeficiency with abnormal lymphocyte profiles.

Billing Considerations

Must document any treatments provided, including stem cell transplants.

Coding Guidelines

Inclusion Criteria

Use D81.39 When
  • According to ICD
  • 10 guidelines, D81
  • 39 should be used when the specific type of adenosine deaminase deficiency is not classified elsewhere
  • It is important to document the clinical findings and laboratory results that support the diagnosis

Exclusion Criteria

Do NOT use D81.39 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81250CPT Code

Genetic testing for adenosine deaminase deficiency

Clinical Scenario

Used when confirming a diagnosis of ADA deficiency.

Documentation Requirements

Documentation of clinical suspicion and rationale for testing.

Specialty Considerations

Pediatric specialists may need to coordinate with genetic counselors.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rare genetic disorders like ADA deficiency, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rare genetic disorders like ADA deficiency, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    Adenosine Deaminase Deficiency Foundation

Coding & Billing References

  • •
    Adenosine Deaminase Deficiency Foundation

Frequently Asked Questions

What is the primary cause of adenosine deaminase deficiency?

Adenosine deaminase deficiency is primarily caused by mutations in the ADA gene, leading to impaired enzyme function and toxic accumulation of adenosine.