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v1.0.0
ICD-10 Guide
ICD-10 CodesE74.31

E74.31

Billable

Sucrase-isomaltase deficiency

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

Code Description

ICD-10 E74.31 is a billable code used to indicate a diagnosis of sucrase-isomaltase deficiency.

Key Diagnostic Point:

Sucrase-isomaltase deficiency is a rare genetic metabolic disorder characterized by the inability to properly digest sucrose and isomaltose due to a deficiency of the sucrase-isomaltase enzyme. This enzyme is crucial for breaking down these sugars into glucose and fructose, which are then absorbed in the intestines. Individuals with this deficiency often experience gastrointestinal symptoms such as abdominal pain, bloating, diarrhea, and flatulence after the ingestion of sucrose-containing foods. The condition is inherited in an autosomal recessive manner, meaning that both copies of the gene must be mutated for the disorder to manifest. Diagnosis typically involves genetic testing and enzyme activity assays. Management focuses on dietary modifications, including the avoidance of sucrose and isomaltose, and may require supplementation with glucose or fructose to ensure adequate nutrition. Early diagnosis and intervention are critical to prevent complications associated with malabsorption and nutritional deficiencies.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic inheritance patterns
  • Involves knowledge of metabolic pathways and enzyme functions
  • Differentiation from other carbohydrate malabsorption disorders
  • Potential for multiple symptoms leading to misdiagnosis

Audit Risk Factors

  • Inadequate documentation of genetic testing results
  • Failure to document dietary modifications and patient education
  • Misclassification of symptoms as unrelated gastrointestinal disorders
  • Lack of follow-up documentation on patient management

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed patient history, symptomatology, and dietary assessments.

Common Clinical Scenarios

Patients presenting with chronic diarrhea and abdominal pain after sucrose ingestion.

Billing Considerations

Ensure documentation reflects the genetic basis of the condition and dietary restrictions.

Genetics

Documentation Requirements

Genetic testing results, family history, and inheritance patterns.

Common Clinical Scenarios

Families with a history of metabolic disorders seeking genetic counseling.

Billing Considerations

Document the implications of genetic findings on patient management and family planning.

Coding Guidelines

Inclusion Criteria

Use E74.31 When
  • Follow ICD
  • CM guidelines for coding metabolic disorders
  • Ensure accurate documentation of the condition's genetic basis and dietary management
  • Include any related symptoms or complications in coding

Exclusion Criteria

Do NOT use E74.31 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81220CPT Code

Genetic testing for sucrase-isomaltase deficiency

Clinical Scenario

Used when a patient presents with symptoms suggestive of carbohydrate malabsorption.

Documentation Requirements

Document the clinical rationale for testing and any family history of metabolic disorders.

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 specific coding of metabolic disorders like sucrase-isomaltase deficiency, improving the accuracy of patient records and facilitating better management strategies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metabolic disorders like sucrase-isomaltase deficiency, improving the accuracy of patient records and facilitating better management strategies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of metabolic disorders like sucrase-isomaltase deficiency, improving the accuracy of patient records and facilitating better management strategies.

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 sucrase-isomaltase deficiency?

Common symptoms include abdominal pain, bloating, diarrhea, and flatulence after consuming sucrose or isomaltose.