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ICD-10 Guide
ICD-10 CodesE72.52

E72.52

Billable

Trimethylaminuria

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

Code Description

ICD-10 E72.52 is a billable code used to indicate a diagnosis of trimethylaminuria.

Key Diagnostic Point:

Trimethylaminuria, also known as fish odor syndrome, is a rare metabolic disorder characterized by the body's inability to break down trimethylamine (TMA), a compound produced during the digestion of certain foods, particularly those rich in choline, such as fish, eggs, and certain legumes. This condition arises from a deficiency in the enzyme flavin-containing monooxygenase 3 (FMO3), which is responsible for converting TMA into a non-odorous compound. As a result, TMA accumulates in the body and is excreted in urine, sweat, and breath, leading to a strong fishy odor. The severity of symptoms can vary widely among individuals, with some experiencing mild odor and others facing significant social and psychological challenges due to the condition. Trimethylaminuria is often inherited in an autosomal recessive pattern, meaning that both copies of the gene must be mutated for the disorder to manifest. Diagnosis typically involves clinical evaluation, dietary history, and biochemical testing to measure TMA levels. Management focuses on dietary modifications to reduce TMA production and may include the use of antibiotics or activated charcoal to help mitigate symptoms.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of metabolic pathways and enzyme deficiencies.
  • Diagnosis often involves genetic testing and biochemical analysis.
  • Symptoms can overlap with other metabolic disorders.
  • Dietary management requires detailed documentation of patient compliance.

Audit Risk Factors

  • Inadequate documentation of dietary history.
  • Failure to document genetic testing results.
  • Misclassification of symptoms as unrelated conditions.
  • Lack of evidence for enzyme deficiency testing.

Specialty Focus

Medical Specialties

Genetics

Documentation Requirements

Detailed family history and genetic testing results.

Common Clinical Scenarios

Patients presenting with unexplained body odor and a family history of metabolic disorders.

Billing Considerations

Ensure accurate coding of genetic tests and counseling sessions.

Nutrition

Documentation Requirements

Comprehensive dietary assessments and patient compliance records.

Common Clinical Scenarios

Patients requiring dietary modifications to manage symptoms.

Billing Considerations

Document specific dietary restrictions and patient education efforts.

Coding Guidelines

Inclusion Criteria

Use E72.52 When
  • According to ICD
  • 10 guidelines, E72
  • 52 should be used when a patient has a confirmed diagnosis of trimethylaminuria, supported by biochemical testing and clinical evaluation

Exclusion Criteria

Do NOT use E72.52 When
  • Exclusion criteria include other metabolic disorders that may present with similar symptoms

Related ICD-10 Codes

Related CPT Codes

81291CPT Code

Genetic testing for FMO3 mutations

Clinical Scenario

Used when confirming a diagnosis of trimethylaminuria.

Documentation Requirements

Document the reason for testing and results.

Specialty Considerations

Genetic counseling may be necessary.

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 trimethylaminuria, improving the accuracy of diagnosis and treatment tracking.

ICD-9 vs ICD-10

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

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    National Organization for Rare Disorders (NORD)

Coding & Billing References

  • •
    National Organization for Rare Disorders (NORD)

Frequently Asked Questions

What is the primary cause of trimethylaminuria?

Trimethylaminuria is primarily caused by a deficiency in the enzyme FMO3, which is responsible for metabolizing trimethylamine.