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ICD-10 Guide
ICD-10 CodesE71.448

E71.448

Billable

Other secondary carnitine deficiency

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

Code Description

ICD-10 E71.448 is a billable code used to indicate a diagnosis of other secondary carnitine deficiency.

Key Diagnostic Point:

Other secondary carnitine deficiency refers to a condition where there is an inadequate supply of carnitine due to secondary causes, such as metabolic disorders, chronic diseases, or certain medications. Carnitine is essential for the transport of long-chain fatty acids into the mitochondria for energy production. Deficiencies can lead to symptoms such as muscle weakness, cardiomyopathy, hypoglycemia, and liver dysfunction. This condition can arise from various underlying issues, including malnutrition, chronic renal failure, or the use of certain drugs that interfere with carnitine metabolism. Diagnosis typically involves biochemical tests to measure carnitine levels in the blood and urine, alongside a thorough clinical evaluation to identify the underlying cause. Management may include dietary modifications, supplementation with carnitine, and addressing the primary condition contributing to the deficiency. Understanding the metabolic pathways and the role of carnitine in fatty acid metabolism is crucial for effective diagnosis and treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of metabolic pathways and carnitine's role in energy metabolism.
  • Differentiation from primary carnitine deficiency and other metabolic disorders.
  • Need for comprehensive patient history to identify secondary causes.
  • Potential overlap with other ICD-10 codes related to metabolic disorders.

Audit Risk Factors

  • Inadequate documentation of the underlying cause of deficiency.
  • Failure to specify the type of secondary carnitine deficiency.
  • Lack of supporting lab results for carnitine levels.
  • Misclassification of the condition as primary deficiency.

Specialty Focus

Medical Specialties

Metabolic Medicine

Documentation Requirements

Detailed metabolic assessments, including biochemical tests and patient history.

Common Clinical Scenarios

Patients presenting with unexplained muscle weakness or cardiomyopathy.

Billing Considerations

Ensure comprehensive metabolic panels are documented to support diagnosis.

Nephrology

Documentation Requirements

Documentation of renal function tests and any medications affecting carnitine levels.

Common Clinical Scenarios

Patients with chronic kidney disease experiencing symptoms of carnitine deficiency.

Billing Considerations

Consideration of dialysis effects on carnitine levels and supplementation needs.

Coding Guidelines

Inclusion Criteria

Use E71.448 When
  • According to ICD
  • 10 guidelines, E71
  • 448 should be used when the deficiency is secondary to another condition
  • Coders must ensure that the primary condition is documented and linked to the carnitine deficiency

Exclusion Criteria

Do NOT use E71.448 When
  • Exclusion criteria include primary carnitine deficiency and other specific metabolic disorders

Related ICD-10 Codes

Related CPT Codes

84140CPT Code

Carnitine, serum

Clinical Scenario

Used to confirm diagnosis of carnitine deficiency.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Metabolic specialists should ensure comprehensive metabolic evaluations are performed.

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, including secondary carnitine deficiency. This specificity aids in better tracking of patient outcomes and resource allocation for treatment.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of metabolic disorders, including secondary carnitine deficiency. This specificity aids in better tracking of patient outcomes and resource allocation for treatment.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of metabolic disorders, including secondary carnitine deficiency. This specificity aids in better tracking of patient outcomes and resource allocation for treatment.

Resources

Clinical References

  • •
    Carnitine Deficiency Overview

Coding & Billing References

  • •
    Carnitine Deficiency Overview

Frequently Asked Questions

What are the common causes of secondary carnitine deficiency?

Common causes include chronic kidney disease, malnutrition, certain medications, and metabolic disorders that affect carnitine metabolism.