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ICD-10 Guide
ICD-10 CodesChapter 4: Endocrine, nutritional and metabolic diseasesE73

E73

Billable

Lactose intolerance

Chapter 4:Endocrine, nutritional and metabolic diseases

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

Code Description

ICD-10 E73 is a billable code used to indicate a diagnosis of lactose intolerance.

Key Diagnostic Point:

Lactose intolerance is a common metabolic disorder characterized by the inability to properly digest lactose, a sugar found in milk and dairy products. This condition arises from a deficiency of lactase, an enzyme produced in the small intestine that is responsible for breaking down lactose into glucose and galactose for absorption. Individuals with lactose intolerance may experience symptoms such as abdominal pain, bloating, diarrhea, and gas after consuming lactose-containing foods. The severity of symptoms can vary based on the amount of lactose ingested and the degree of lactase deficiency. Lactose intolerance can be classified into three types: primary, secondary, and congenital. Primary lactose intolerance is the most common form, typically developing in adulthood as lactase production decreases. Secondary lactose intolerance can occur due to injury to the small intestine from infections, diseases, or surgeries. Congenital lactose intolerance is a rare genetic condition where infants are born with little to no lactase enzyme. Diagnosis is often made through clinical evaluation and tests such as the hydrogen breath test or lactose tolerance test. Management primarily involves dietary modifications to limit lactose intake and may include lactase enzyme supplements.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary and secondary lactose intolerance
  • Understanding dietary implications and patient education
  • Recognizing associated conditions that may complicate diagnosis
  • Interpreting diagnostic test results accurately

Audit Risk Factors

  • Inadequate documentation of symptoms and dietary history
  • Misclassification of lactose intolerance type
  • Failure to document associated conditions
  • Inconsistent use of diagnostic tests

Specialty Focus

Medical Specialties

Gastroenterology

Documentation Requirements

Detailed patient history, symptom diary, and results of diagnostic tests.

Common Clinical Scenarios

Patients presenting with gastrointestinal symptoms after dairy consumption.

Billing Considerations

Ensure documentation includes the type of lactose intolerance and any dietary modifications recommended.

Pediatrics

Documentation Requirements

Growth charts, dietary history, and parental reports of symptoms.

Common Clinical Scenarios

Infants or children with gastrointestinal distress after milk intake.

Billing Considerations

Document any congenital conditions and family history of lactose intolerance.

Coding Guidelines

Inclusion Criteria

Use E73 When
  • According to ICD
  • 10 guidelines, E73 is used for lactose intolerance not classified elsewhere
  • It is important to document the type of lactose intolerance when applicable and to ensure that the diagnosis is supported by clinical findings and patient history

Exclusion Criteria

Do NOT use E73 When
No specific exclusions found.

Related CPT Codes

83018CPT Code

Lactose tolerance test

Clinical Scenario

Used to confirm lactose intolerance diagnosis.

Documentation Requirements

Document the test results and patient symptoms.

Specialty Considerations

Gastroenterologists should ensure proper interpretation of test results.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of lactose intolerance, enabling better tracking of the condition and its management. The granularity of codes helps in understanding the prevalence and treatment outcomes of lactose intolerance in various populations.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of lactose intolerance, enabling better tracking of the condition and its management. The granularity of codes helps in understanding the prevalence and treatment outcomes of lactose intolerance in various populations.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    National Institute of Diabetes and Digestive and Kidney Diseases

Coding & Billing References

  • •
    National Institute of Diabetes and Digestive and Kidney Diseases

Frequently Asked Questions

What are the common symptoms of lactose intolerance?

Common symptoms include bloating, diarrhea, gas, and abdominal pain after consuming lactose-containing foods.

How is lactose intolerance diagnosed?

Diagnosis is typically made through patient history, dietary assessments, and tests such as the hydrogen breath test or lactose tolerance test.

Can lactose intolerance be treated?

Management primarily involves dietary modifications to limit lactose intake and may include lactase enzyme supplements to aid digestion.