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ICD-10 Guide
ICD-10 CodesR85.0

R85.0

Abnormal level of enzymes in specimens from digestive organs and abdominal cavity

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R85.0 is a billable code used to indicate a diagnosis of abnormal level of enzymes in specimens from digestive organs and abdominal cavity.

Key Diagnostic Point:

R85.0 refers to abnormal enzyme levels detected in specimens obtained from the digestive organs and abdominal cavity. These enzymes, which include amylase, lipase, and various liver enzymes, can indicate underlying pathologies such as pancreatitis, liver disease, or biliary obstruction. The presence of elevated or decreased enzyme levels can be symptomatic of acute or chronic conditions affecting the digestive system. For instance, elevated amylase and lipase levels are commonly associated with pancreatitis, while abnormal liver enzymes may suggest hepatocellular injury or cholestasis. Accurate interpretation of these enzyme levels requires correlation with clinical symptoms, imaging studies, and other laboratory findings to establish a definitive diagnosis. The abnormal enzyme levels may not be specific to one condition, necessitating a thorough clinical evaluation to determine the underlying cause.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of potential underlying conditions
  • Need for correlation with clinical findings
  • Variability in enzyme levels based on patient demographics
  • Potential for overlapping symptoms with other diagnoses

Audit Risk Factors

  • Inadequate documentation of clinical correlation
  • Failure to specify the type of enzyme abnormality
  • Misinterpretation of enzyme levels without context
  • Coding without supporting lab results

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed clinical history, physical examination findings, and lab results must be documented to support the diagnosis.

Common Clinical Scenarios

Patients presenting with abdominal pain, jaundice, or unexplained weight loss may have abnormal enzyme levels.

Billing Considerations

Consideration of comorbidities and medications that may affect enzyme levels is crucial.

Emergency Medicine

Documentation Requirements

Acute care documentation must include time-sensitive lab results and immediate clinical findings.

Common Clinical Scenarios

Patients with acute abdominal pain or suspected acute pancreatitis presenting to the emergency department.

Billing Considerations

Rapid assessment and documentation of enzyme levels are critical for timely intervention.

Coding Guidelines

Inclusion Criteria

Use R85.0 When
  • Follow the official ICD
  • CM coding guidelines, ensuring that the code is used only when enzyme abnormalities are documented and clinically relevant
  • Ensure specificity in documentation to support the diagnosis

Exclusion Criteria

Do NOT use R85.0 When
No specific exclusions found.

Related CPT Codes

80053CPT Code

Comprehensive metabolic panel

Clinical Scenario

Used to evaluate liver and kidney function, including enzyme levels.

Documentation Requirements

Document the reason for the metabolic panel and any relevant clinical findings.

Specialty Considerations

Internal medicine and emergency medicine often utilize this panel for initial assessments.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of enzyme abnormalities, improving the accuracy of diagnoses and treatment plans.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of enzyme abnormalities, improving the accuracy of diagnoses and treatment plans.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of enzyme abnormalities, improving the accuracy of diagnoses and treatment plans.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What are the common causes of abnormal enzyme levels?

Common causes include pancreatitis, liver disease, biliary obstruction, and certain medications that can affect enzyme levels.