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v1.0.0
ICD-10 Guide
ICD-10 CodesE72.4

E72.4

Billable

Disorders of ornithine metabolism

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

Code Description

ICD-10 E72.4 is a billable code used to indicate a diagnosis of disorders of ornithine metabolism.

Key Diagnostic Point:

Disorders of ornithine metabolism are a group of rare genetic metabolic conditions characterized by the body's inability to properly metabolize ornithine, an amino acid that plays a crucial role in the urea cycle. This cycle is essential for removing ammonia from the bloodstream, a toxic byproduct of protein metabolism. Deficiencies in specific enzymes, such as ornithine transcarbamylase (OTC), can lead to an accumulation of ammonia, resulting in hyperammonemia, which can cause neurological damage and other serious health issues. Symptoms may include lethargy, vomiting, seizures, and in severe cases, coma. Diagnosis typically involves biochemical tests to measure ammonia levels and genetic testing to identify specific enzyme deficiencies. Management often includes dietary modifications, ammonia scavengers, and in some cases, liver transplantation. Early diagnosis and intervention are critical to prevent irreversible damage and improve outcomes for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of enzyme deficiencies leading to similar symptoms
  • Need for genetic testing to confirm diagnosis
  • Potential for overlapping symptoms with other metabolic disorders
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of enzyme testing results
  • Failure to document dietary management plans
  • Lack of genetic testing results in the medical record
  • Misdiagnosis due to symptom overlap with other conditions

Specialty Focus

Medical Specialties

Genetics

Documentation Requirements

Detailed family history and genetic test results must be documented.

Common Clinical Scenarios

Patients presenting with unexplained hyperammonemia or neurological symptoms.

Billing Considerations

Genetic counseling may be necessary for family planning and understanding inheritance patterns.

Pediatrics

Documentation Requirements

Growth and developmental assessments, along with dietary history.

Common Clinical Scenarios

Infants with failure to thrive or developmental delays.

Billing Considerations

Monitoring for acute metabolic crises and ensuring timely dietary interventions.

Coding Guidelines

Inclusion Criteria

Use E72.4 When
  • Follow the official ICD
  • CM coding guidelines for metabolic disorders
  • Ensure accurate documentation of the specific enzyme deficiency and any related complications
  • Include relevant laboratory results and genetic testing outcomes

Exclusion Criteria

Do NOT use E72.4 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81240CPT Code

Genetic testing for ornithine transcarbamylase deficiency

Clinical Scenario

Used when confirming a diagnosis of ornithine metabolism disorder.

Documentation Requirements

Document the clinical rationale for genetic testing and results.

Specialty Considerations

Geneticists should ensure comprehensive family history is included.

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, improving the accuracy of diagnoses and treatment tracking for conditions like E72.4.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metabolic disorders, improving the accuracy of diagnoses and treatment tracking for conditions like E72.4.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of metabolic disorders, improving the accuracy of diagnoses and treatment tracking for conditions like E72.4.

Resources

Clinical References

  • •
    National Organization for Rare Disorders (NORD)

Coding & Billing References

  • •
    National Organization for Rare Disorders (NORD)

Frequently Asked Questions

What are the common symptoms of disorders of ornithine metabolism?

Common symptoms include lethargy, vomiting, seizures, and neurological impairment due to elevated ammonia levels.