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ICD-10 Guide
ICD-10 CodesE71.121

E71.121

Billable

Propionic acidemia

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

Code Description

ICD-10 E71.121 is a billable code used to indicate a diagnosis of propionic acidemia.

Key Diagnostic Point:

Propionic acidemia is a rare inherited metabolic disorder caused by a deficiency of the enzyme propionyl-CoA carboxylase, which is crucial for the metabolism of certain amino acids (isoleucine, valine, threonine, and methionine) and odd-chain fatty acids. This deficiency leads to the accumulation of propionic acid in the blood, resulting in metabolic acidosis and a range of clinical symptoms. Patients may present with vomiting, lethargy, hypotonia, and developmental delays. Severe cases can lead to life-threatening complications such as seizures, coma, and even death if not promptly managed. Diagnosis is typically confirmed through newborn screening, biochemical analysis of blood and urine, and genetic testing to identify mutations in the PCC gene. Management includes dietary restrictions to limit protein intake, supplementation with carnitine, and in some cases, emergency interventions to correct metabolic crises. Long-term management focuses on monitoring metabolic status and preventing acute episodes.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of metabolic pathways and enzyme functions.
  • Differentiation from other organic acidemias can be challenging.
  • Documentation must include specific metabolic testing results.
  • Management strategies vary significantly based on severity and age.

Audit Risk Factors

  • Inadequate documentation of metabolic testing results.
  • Failure to document dietary management plans.
  • Misclassification with other organic acidemias.
  • Lack of genetic testing documentation.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of metabolic crises, dietary management plans, and growth parameters.

Common Clinical Scenarios

Newborn screening positive for propionic acidemia, management of acute metabolic crisis.

Billing Considerations

Close monitoring of developmental milestones and nutritional status is essential.

Genetics

Documentation Requirements

Genetic testing results, family history of metabolic disorders.

Common Clinical Scenarios

Counseling families with a history of propionic acidemia, interpreting genetic test results.

Billing Considerations

Documentation must clearly link genetic findings to clinical symptoms.

Coding Guidelines

Inclusion Criteria

Use E71.121 When
  • Follow ICD
  • CM guidelines for coding metabolic disorders, ensuring specificity in documentation
  • Include relevant lab results and clinical findings to support the diagnosis
  • existing

Exclusion Criteria

Do NOT use E71.121 When
  • Exclude codes for other organic acidemias unless co

Related ICD-10 Codes

Related CPT Codes

81200CPT Code

Genetic testing for propionic acidemia

Clinical Scenario

Used when confirming a diagnosis of propionic acidemia through genetic testing.

Documentation Requirements

Documentation of clinical symptoms and family history is required.

Specialty Considerations

Genetic specialists should ensure that all relevant family history is documented.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of metabolic disorders like propionic acidemia, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and resource utilization.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metabolic disorders like propionic acidemia, improving the accuracy of data collection and reimbursement processes. It has also facilitated better tracking of patient outcomes and resource utilization.

Reimbursement & Billing Impact

reimbursement processes. It has also facilitated better tracking of patient outcomes and resource utilization.

Resources

Clinical References

  • •
    Propionic Acidemia Foundation

Coding & Billing References

  • •
    Propionic Acidemia Foundation

Frequently Asked Questions

What are the common symptoms of propionic acidemia?

Common symptoms include vomiting, lethargy, hypotonia, seizures, and developmental delays. Symptoms often present in the first few days of life.