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v1.0.0
ICD-10 Guide
DiagnosesAmyloidosis

Amyloidosis

ICD-10 Coding for Amyloidosis(E85.81, E85.82)

PRIMARY SPECIALTYCardiology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Amyloidosis?
Essential facts and insights about Amyloidosis

Key Clinical Considerations:

  • Presence of amyloid deposits in tissues, confirmed by biopsy
  • Laboratory findings such as elevated serum amyloid A protein (SAA) or abnormal light chain levels
  • Physical examination may reveal signs of organ dysfunction, such as cardiomyopathy or nephrotic syndrome
  • Imaging findings may include echocardiographic evidence of cardiac involvement or MRI findings of organ infiltration
  • Staging based on organ involvement and functional impairment, such as NYHA classification for heart failure

Clinical Information

Clinical Criteria & Documentation Requirements

  • Complete medical history including symptoms, duration, and progression of disease
  • Specific terminology such as 'amyloidosis', 'light chain amyloidosis', or 'AA amyloidosis' must be documented
  • Examples include documenting the type of amyloidosis and affected organs, e.g., 'AL amyloidosis affecting the heart'
  • Medical necessity must be established through documentation of symptoms and diagnostic testing
  • Quality measures may include documentation of functional status and treatment response

Coding Guidelines

Usage Guidelines & Examples

  • Use E85.81 for AL amyloidosis and E85.82 for AA amyloidosis based on the underlying cause
  • Do NOT use these codes for conditions that do not involve amyloid deposits, such as cardiac hypertrophy without amyloidosis
  • Related codes include E85.0 for localized amyloidosis and E85.9 for unspecified amyloidosis
  • Common errors include misclassifying the type of amyloidosis or failing to document the underlying cause
  • In complex cases, ensure to document all affected organs and the specific type of amyloidosis for accurate code selection

Code Exclusions

Important Exclusions

  • Excludes conditions like cardiac amyloidosis due to other causes not related to amyloid deposits
  • Alternative codes for excluded conditions may include I42.9 for unspecified cardiomyopathy
  • Conditions are excluded due to differing pathophysiology and treatment approaches
  • Common mistakes include coding amyloidosis when the primary condition is unrelated to amyloid deposits
  • Related but distinct conditions include sarcoidosis and hemochromatosis, which may mimic amyloidosis

Related ICD-10 Codes

Primary Codes
E85.81
Light chain (AL) amyloidosis
E85.82
Secondary (AA) amyloidosis
Ancillary Codes
I43
G60.8
Differential Codes
E85.82
E85.82
for confirmed ATTR amyloidosis with genetic testing.
E85.81
E85.81
for confirmed AL amyloidosis with light chain involvement.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Cardiology

Specialty Applications

  • Applies to patients with systemic amyloidosis affecting multiple organs
  • Patient populations include adults, with increased risk in those with chronic inflammatory diseases
  • Clinical settings include inpatient for severe cases and outpatient for monitoring and management
  • Specialty-specific applications in cardiology, nephrology, and hematology
  • Treatment contexts include chemotherapy for AL amyloidosis and supportive care for organ dysfunction

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with amyloidosis based on biopsy findings and elevated serum amyloid A levels.'

Template 2

Template: 'Clinical presentation consistent with AL amyloidosis including fatigue, weight loss, and cardiac symptoms.'

Template 3

Template: 'Diagnostic criteria for amyloidosis met as evidenced by tissue biopsy showing amyloid deposits.'

Template 4

Template: 'Treatment plan initiated for amyloidosis with chemotherapy and supportive care measures.'

Template 5

Template: 'Follow-up care for amyloidosis including monitoring of cardiac function and renal status.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Detailed documentation of clinical findings, biopsy results, and organ involvement is required.

How does this differ from similar diagnoses?

Amyloidosis is characterized by amyloid deposits, while other conditions may involve different types of protein deposits.

What are common billing considerations?

Ensure that the diagnosis is supported by clinical documentation and that the correct type of amyloidosis is coded.

What procedures are typically associated?

Related CPT codes may include echocardiograms, biopsies, and laboratory tests for amyloid proteins.

Are there any quality reporting implications?

Quality measures may include tracking treatment outcomes and functional status in patients with amyloidosis.