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ICD-10 Guide
ICD-10 CodesE71.128

E71.128

Billable

Other disorders of propionate metabolism

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

Code Description

ICD-10 E71.128 is a billable code used to indicate a diagnosis of other disorders of propionate metabolism.

Key Diagnostic Point:

E71.128 refers to a group of metabolic disorders characterized by the abnormal metabolism of propionate, a short-chain fatty acid. These disorders are often due to enzyme deficiencies that disrupt the normal catabolism of propionate, leading to its accumulation in the body. Commonly associated conditions include propionic acidemia, which results from a deficiency in the enzyme propionyl-CoA carboxylase. This enzyme is crucial for converting propionyl-CoA to methylmalonyl-CoA, a key step in the metabolism of certain amino acids and odd-chain fatty acids. Symptoms of propionic acidemia can include metabolic acidosis, developmental delays, and neurological impairments. Diagnosis typically involves biochemical testing to measure organic acids in urine and plasma, alongside genetic testing to identify specific enzyme deficiencies. Management often requires dietary modifications to limit protein intake and the use of supplements to manage metabolic derangements. Early diagnosis and intervention are critical to improving outcomes and preventing severe complications.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying genetic conditions
  • Need for biochemical testing for accurate diagnosis
  • Potential for overlapping symptoms with other metabolic disorders
  • Requirement for detailed family history and genetic counseling

Audit Risk Factors

  • Inadequate documentation of biochemical testing results
  • Failure to document family history of metabolic disorders
  • Misclassification of symptoms as unrelated conditions
  • Lack of genetic testing results in the medical record

Specialty Focus

Medical Specialties

Genetics

Documentation Requirements

Detailed family history, genetic test results, and clinical findings.

Common Clinical Scenarios

Patients presenting with developmental delays and metabolic acidosis.

Billing Considerations

Ensure genetic counseling is documented, as it is crucial for understanding inheritance patterns.

Pediatrics

Documentation Requirements

Growth charts, developmental assessments, and dietary management plans.

Common Clinical Scenarios

Infants with failure to thrive and unexplained metabolic crises.

Billing Considerations

Documenting dietary restrictions and metabolic management strategies is essential.

Coding Guidelines

Inclusion Criteria

Use E71.128 When
  • Follow ICD
  • CM guidelines for coding metabolic disorders, ensuring accurate documentation of biochemical tests and genetic findings
  • Include any relevant symptoms and complications to support the diagnosis

Exclusion Criteria

Do NOT use E71.128 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81200CPT Code

Genetic testing for propionic acidemia

Clinical Scenario

Used when genetic confirmation of propionic acidemia is needed.

Documentation Requirements

Document the reason for genetic testing and results.

Specialty Considerations

Genetic counseling should be documented as part of the testing process.

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, improving the ability to track and manage these conditions. E71.128 provides a broader category for disorders of propionate metabolism, facilitating better data collection and research.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metabolic disorders, improving the ability to track and manage these conditions. E71.128 provides a broader category for disorders of propionate metabolism, facilitating better data collection and research.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of metabolic disorders, improving the ability to track and manage these conditions. E71.128 provides a broader category for disorders of propionate metabolism, facilitating better data collection and research.

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 disorders of propionate metabolism?

Common symptoms include metabolic acidosis, vomiting, lethargy, developmental delays, and neurological impairments. Symptoms can vary widely based on the specific disorder and the age of onset.