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v1.0.0
ICD-10 Guide
ICD-10 CodesE74.02

E74.02

Billable

Pompe disease

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

Code Description

ICD-10 E74.02 is a billable code used to indicate a diagnosis of pompe disease.

Key Diagnostic Point:

Pompe disease, also known as glycogen storage disease type II, is a rare genetic disorder caused by the deficiency of the enzyme acid alpha-glucosidase (GAA). This enzyme is crucial for the breakdown of glycogen, a stored form of glucose, into glucose that the body can use for energy. In individuals with Pompe disease, the lack of GAA leads to the accumulation of glycogen in various tissues, particularly in muscle cells, which can result in progressive muscle weakness and respiratory issues. The disease can present in two forms: infantile-onset Pompe disease, which manifests within the first few months of life and is characterized by severe hypotonia, cardiomyopathy, and early death if untreated; and late-onset Pompe disease, which typically appears in childhood or adulthood and progresses more slowly, primarily affecting skeletal muscles and leading to mobility issues. Diagnosis is confirmed through enzyme assays and genetic testing. Treatment options include enzyme replacement therapy (ERT) and supportive care, which can significantly improve quality of life and prolong survival.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Requires understanding of genetic testing and enzyme assays.
  • Differentiation between infantile and late-onset forms.
  • Potential for co-morbid conditions affecting coding.
  • Need for accurate documentation of clinical presentation and treatment.

Audit Risk Factors

  • Inadequate documentation of enzyme testing results.
  • Failure to specify the type of Pompe disease (infantile vs. late-onset).
  • Misclassification of symptoms or severity.
  • Lack of supporting documentation for enzyme replacement therapy.

Specialty Focus

Medical Specialties

Genetics

Documentation Requirements

Detailed family history and genetic testing results.

Common Clinical Scenarios

Patients undergoing genetic counseling or testing for Pompe disease.

Billing Considerations

Ensure clarity in genetic test results and implications for family members.

Neurology

Documentation Requirements

Comprehensive neurological assessments and muscle function evaluations.

Common Clinical Scenarios

Patients presenting with muscle weakness or respiratory issues.

Billing Considerations

Document progression of symptoms and response to treatment.

Coding Guidelines

Inclusion Criteria

Use E74.02 When
  • Follow official ICD
  • 10 coding guidelines, ensuring accurate documentation of the condition's type and severity
  • Include relevant laboratory results and genetic testing outcomes to support the diagnosis

Exclusion Criteria

Do NOT use E74.02 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

81200CPT Code

Genetic testing for GAA mutations

Clinical Scenario

Used when confirming a diagnosis of Pompe disease.

Documentation Requirements

Document the reason for testing and results.

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 Pompe disease, enabling better tracking of the condition and its management. This specificity aids in research and improves patient care by ensuring appropriate treatment protocols are followed.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of Pompe disease, enabling better tracking of the condition and its management. This specificity aids in research and improves patient care by ensuring appropriate treatment protocols are followed.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of Pompe disease, enabling better tracking of the condition and its management. This specificity aids in research and improves patient care by ensuring appropriate treatment protocols are followed.

Resources

Clinical References

  • •
    Pompe Disease: A Guide for Patients and Families

Coding & Billing References

  • •
    Pompe Disease: A Guide for Patients and Families

Frequently Asked Questions

What is the primary cause of Pompe disease?

Pompe disease is primarily caused by a deficiency of the enzyme acid alpha-glucosidase due to mutations in the GAA gene.

How is Pompe disease diagnosed?

Diagnosis is made through enzyme assays that measure GAA activity and genetic testing to identify mutations in the GAA gene.

What are the treatment options for Pompe disease?

Treatment options include enzyme replacement therapy, supportive care, and management of symptoms to improve quality of life.