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ICD-10 Guide
ICD-10 CodesE71.110

E71.110

Billable

Isovaleric acidemia

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

Code Description

ICD-10 E71.110 is a billable code used to indicate a diagnosis of isovaleric acidemia.

Key Diagnostic Point:

Isovaleric acidemia (IVA) is a rare autosomal recessive metabolic disorder characterized by a deficiency of the enzyme isovaleryl-CoA dehydrogenase, which is crucial for the metabolism of the branched-chain amino acid leucine. This deficiency leads to the accumulation of isovaleric acid in the body, resulting in a range of clinical manifestations. Symptoms typically present in infancy and can include metabolic acidosis, lethargy, vomiting, and a distinctive 'sweaty feet' odor due to the accumulation of isovaleric acid. If left untreated, IVA can lead to severe neurological damage and can be life-threatening. Diagnosis is confirmed through urine organic acid analysis, which reveals elevated levels of isovaleric acid. Management involves dietary restrictions to limit leucine intake and supplementation with carnitine to help remove excess isovaleric acid. Early diagnosis and intervention are critical to improving outcomes for affected individuals.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of metabolic pathways and enzyme deficiencies.
  • Differentiation from other organic acidemias can be challenging.
  • Documentation must specify the type of metabolic disorder.
  • Potential for co-morbid conditions complicating the clinical picture.

Audit Risk Factors

  • Inadequate documentation of enzyme deficiency.
  • Failure to include laboratory results in the medical record.
  • Misclassification of the disorder as a different metabolic condition.
  • Lack of clear clinical indicators for diagnosis.

Specialty Focus

Medical Specialties

Pediatrics

Documentation Requirements

Detailed history of symptoms, family history of metabolic disorders, and results from metabolic testing.

Common Clinical Scenarios

Infants presenting with vomiting, lethargy, and unusual odor.

Billing Considerations

Close monitoring of dietary intake and metabolic status is essential.

Genetics

Documentation Requirements

Genetic testing results, family pedigree, and metabolic screening outcomes.

Common Clinical Scenarios

Patients with a family history of metabolic disorders undergoing genetic counseling.

Billing Considerations

Documentation should include genetic counseling notes and recommendations for family screening.

Coding Guidelines

Inclusion Criteria

Use E71.110 When
  • Follow ICD
  • CM guidelines for coding metabolic disorders, ensuring specificity in documentation
  • Include any relevant laboratory findings and clinical indicators that support the diagnosis of isovaleric acidemia

Exclusion Criteria

Do NOT use E71.110 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81403CPT Code

Genetic testing for metabolic disorders

Clinical Scenario

Used when genetic confirmation of isovaleric acidemia is needed.

Documentation Requirements

Documentation of clinical suspicion and family history.

Specialty Considerations

Genetic counseling may be required for family members.

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 isovaleric acidemia, improving the accuracy of data collection and reimbursement processes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metabolic disorders like isovaleric acidemia, improving the accuracy of data collection and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

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 isovaleric acidemia?

Common symptoms include metabolic acidosis, lethargy, vomiting, and a distinctive odor resembling sweaty feet.

How is isovaleric acidemia diagnosed?

Diagnosis is typically made through urine organic acid analysis, which shows elevated levels of isovaleric acid.

What is the management for isovaleric acidemia?

Management includes dietary restrictions to limit leucine intake and supplementation with carnitine to help remove excess isovaleric acid.