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ICD-10 Guide
ICD-10 CodesE73.9

E73.9

Billable

Lactose intolerance, unspecified

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

Code Description

ICD-10 E73.9 is a billable code used to indicate a diagnosis of lactose intolerance, unspecified.

Key Diagnostic Point:

Lactose intolerance is a common metabolic disorder characterized by the inability to digest lactose, a sugar found in milk and dairy products, due to a deficiency of the enzyme lactase. This condition can lead to gastrointestinal symptoms such as bloating, diarrhea, and abdominal pain after the consumption of lactose-containing foods. The severity of symptoms can vary widely among individuals, depending on the amount of lactase produced and the quantity of lactose ingested. Lactose intolerance can be classified into primary, secondary, and congenital forms. Primary lactose intolerance is the most common type, resulting from a decrease in lactase production after weaning. Secondary lactose intolerance can occur due to damage to the intestinal lining from infections, diseases, or medications. Congenital lactose intolerance is a rare genetic condition where infants are born with little to no lactase enzyme. The unspecified designation in E73.9 indicates that the specific type or cause of lactose intolerance has not been determined, which may complicate diagnosis and management. Accurate coding is essential for appropriate treatment and dietary recommendations.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in symptoms and severity among patients
  • Differentiation from other gastrointestinal disorders
  • Need for dietary assessment and patient history
  • Potential overlap with other enzyme deficiencies

Audit Risk Factors

  • Inadequate documentation of symptoms
  • Failure to specify type of lactose intolerance
  • Misdiagnosis with other gastrointestinal conditions
  • Lack of dietary history in patient records

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed patient history, symptom description, and dietary assessments.

Common Clinical Scenarios

Patients presenting with abdominal pain, bloating, and diarrhea after dairy consumption.

Billing Considerations

Consideration of differential diagnoses such as IBS or IBD.

Pediatrics

Documentation Requirements

Growth charts, dietary intake assessments, and family history of lactose intolerance.

Common Clinical Scenarios

Infants or children with gastrointestinal symptoms after milk intake.

Billing Considerations

Monitoring for nutritional deficiencies in children with lactose intolerance.

Coding Guidelines

Inclusion Criteria

Use E73.9 When
  • According to ICD
  • 10 guidelines, E73
  • 9 should be used when lactose intolerance is diagnosed but not specified as primary, secondary, or congenital
  • Documentation must support the diagnosis and indicate that lactose intolerance is the primary reason for the visit

Exclusion Criteria

Do NOT use E73.9 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

82560CPT Code

Lactose tolerance test

Clinical Scenario

Used to confirm lactose intolerance diagnosis.

Documentation Requirements

Document the rationale for testing and patient symptoms.

Specialty Considerations

Gastroenterology may require additional tests to rule out other conditions.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lactose intolerance, improving the ability to track and manage the condition. However, the unspecified nature of E73.9 can lead to challenges in clinical documentation and treatment planning.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lactose intolerance, improving the ability to track and manage the condition. However, the unspecified nature of E73.9 can lead to challenges in clinical documentation and treatment planning.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of lactose intolerance, improving the ability to track and manage the condition. However, the unspecified nature of E73.9 can lead to challenges in clinical documentation and treatment planning.

Resources

Clinical References

  • •
    Lactose Intolerance: A Guide for Patients

Coding & Billing References

  • •
    Lactose Intolerance: A Guide for Patients

Frequently Asked Questions

What is lactose intolerance?

Lactose intolerance is the inability to digest lactose due to a deficiency of the enzyme lactase, leading to gastrointestinal symptoms after consuming dairy products.

How is lactose intolerance diagnosed?

Diagnosis is typically made through patient history, dietary assessments, and may be confirmed with tests such as hydrogen breath tests.