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v1.0.0
ICD-10 Guide
ICD-10 CodesE72.53

E72.53

Billable

Primary hyperoxaluria

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

Code Description

ICD-10 E72.53 is a billable code used to indicate a diagnosis of primary hyperoxaluria.

Key Diagnostic Point:

Primary hyperoxaluria is a rare genetic metabolic disorder characterized by excessive production of oxalate, leading to the formation of calcium oxalate crystals in the kidneys, urinary tract, and other tissues. This condition is primarily caused by deficiencies in specific enzymes involved in glyoxylate metabolism, particularly alanine-glyoxylate aminotransferase (AGT) in type 1, glyoxylate reductase/hydroxypyruvate reductase (GRHPR) in type 2, and lactate dehydrogenase A (LDHA) in type 3. The accumulation of oxalate can result in kidney stones, nephrocalcinosis, and ultimately renal failure if left untreated. Patients may present with symptoms such as flank pain, hematuria, and recurrent urinary tract infections. Diagnosis typically involves biochemical testing to measure oxalate levels in urine and plasma, as well as genetic testing to confirm the specific enzyme deficiency. Management strategies include hydration, dietary modifications to reduce oxalate intake, and in severe cases, renal replacement therapy or liver transplantation to correct the underlying metabolic defect.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Genetic testing documentation requirements
  • Variability in clinical presentation
  • Need for multidisciplinary management
  • Potential for renal complications

Audit Risk Factors

  • Inadequate documentation of genetic testing
  • Failure to document enzyme deficiencies
  • Misclassification with secondary hyperoxaluria
  • Lack of detailed clinical history

Specialty Focus

Medical Specialties

Nephrology

Documentation Requirements

Detailed renal function tests, imaging studies, and history of kidney stones.

Common Clinical Scenarios

Patients presenting with recurrent kidney stones or renal failure.

Billing Considerations

Ensure documentation reflects the metabolic nature of the condition and any renal complications.

Genetics

Documentation Requirements

Genetic testing results, family history, and metabolic evaluations.

Common Clinical Scenarios

Patients with a family history of kidney stones or unexplained renal failure.

Billing Considerations

Document the specific genetic mutations identified and their implications for treatment.

Coding Guidelines

Inclusion Criteria

Use E72.53 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's genetic basis and any associated complications
  • Include relevant laboratory results and clinical findings

Exclusion Criteria

Do NOT use E72.53 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81240CPT Code

Genetic testing for primary hyperoxaluria

Clinical Scenario

Used when confirming a diagnosis of primary hyperoxaluria through genetic analysis.

Documentation Requirements

Document the necessity of genetic testing based on clinical presentation and family history.

Specialty Considerations

Genetic specialists 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 precise coding of primary hyperoxaluria, facilitating better tracking of this rare condition and its management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more precise coding of primary hyperoxaluria, facilitating better tracking of this rare condition and its management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more precise coding of primary hyperoxaluria, facilitating better tracking of this rare condition and its management.

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 primary hyperoxaluria?

Primary hyperoxaluria is primarily caused by genetic deficiencies in enzymes responsible for oxalate metabolism, leading to excessive oxalate production.