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ICD-10 Guide
ICD-10 CodesE55.0

E55.0

Billable

Rickets, active

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

Code Description

ICD-10 E55.0 is a billable code used to indicate a diagnosis of rickets, active.

Key Diagnostic Point:

Rickets is a skeletal disorder characterized by the softening and weakening of bones in children, primarily due to a deficiency in vitamin D, calcium, or phosphate. Active rickets occurs when there is a significant deficiency of vitamin D, leading to impaired calcium absorption and subsequent bone mineralization. This condition manifests as bone pain, delayed growth, and skeletal deformities such as bowed legs or a protruding abdomen. The primary cause of rickets is inadequate dietary intake of vitamin D, often exacerbated by limited sun exposure, particularly in populations with darker skin or those living in northern latitudes. Other contributing factors include malabsorption syndromes and certain genetic disorders. Diagnosis is typically confirmed through clinical evaluation, radiographic findings, and laboratory tests showing low serum levels of vitamin D and calcium. Treatment involves nutritional supplementation with vitamin D and calcium, alongside dietary modifications to ensure adequate intake of these essential nutrients.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variability in clinical presentation among patients
  • Need for comprehensive dietary history
  • Potential overlap with other vitamin deficiencies
  • Documentation of laboratory results and imaging studies

Audit Risk Factors

  • Inadequate documentation of dietary intake
  • Failure to document laboratory results
  • Lack of clear clinical correlation between symptoms and diagnosis
  • Misclassification of rickets severity

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed growth charts, dietary assessments, and laboratory results.

Common Clinical Scenarios

Children presenting with bone pain, delayed milestones, or skeletal deformities.

Billing Considerations

Ensure that all relevant dietary and environmental factors are documented.

Endocrinology

Documentation Requirements

Thorough evaluation of metabolic bone disease, including hormonal assessments.

Common Clinical Scenarios

Patients with underlying metabolic disorders affecting calcium and vitamin D metabolism.

Billing Considerations

Document any underlying conditions that may contribute to rickets.

Coding Guidelines

Inclusion Criteria

Use E55.0 When
  • According to ICD
  • 10 guidelines, E55
  • 0 should be used when there is clear evidence of active rickets due to vitamin D deficiency
  • Documentation must include clinical symptoms, laboratory findings, and any relevant dietary history

Exclusion Criteria

Do NOT use E55.0 When
  • Exclusion criteria include other causes of bone weakness not related to vitamin D deficiency

Related ICD-10 Codes

Related CPT Codes

99213CPT Code

Established patient office visit, Level 3

Clinical Scenario

Used for follow-up visits to monitor rickets treatment.

Documentation Requirements

Document history, examination findings, and treatment plan.

Specialty Considerations

Pediatricians should ensure growth parameters are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of rickets, enabling better tracking of vitamin D deficiency and its impact on pediatric health. This specificity aids in research and public health initiatives aimed at addressing nutritional deficiencies.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of rickets, enabling better tracking of vitamin D deficiency and its impact on pediatric health. This specificity aids in research and public health initiatives aimed at addressing nutritional deficiencies.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of rickets, enabling better tracking of vitamin D deficiency and its impact on pediatric health. This specificity aids in research and public health initiatives aimed at addressing nutritional deficiencies.

Resources

Clinical References

  • •
    National Institutes of Health - Vitamin D

Coding & Billing References

  • •
    National Institutes of Health - Vitamin D

Frequently Asked Questions

What are the common symptoms of active rickets?

Common symptoms include bone pain, delayed growth, skeletal deformities such as bowed legs, and muscle weakness.

How is rickets diagnosed?

Rickets is diagnosed through clinical evaluation, radiographic findings, and laboratory tests showing low levels of vitamin D and calcium.

What dietary changes can help prevent rickets?

Increasing intake of vitamin D-rich foods such as fatty fish, fortified dairy products, and egg yolks, along with adequate sun exposure, can help prevent rickets.