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ICD-10 Guide
ICD-10 CodesR78.7

R78.7

Finding of abnormal level of heavy metals in blood

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/11/2025

Code Description

ICD-10 R78.7 is a billable code used to indicate a diagnosis of finding of abnormal level of heavy metals in blood.

Key Diagnostic Point:

R78.7 indicates the presence of abnormal levels of heavy metals in the blood, which can be indicative of various toxic exposures or underlying health conditions. Heavy metals such as lead, mercury, arsenic, and cadmium can accumulate in the body and lead to significant health issues, including neurological, renal, and hematological disorders. Symptoms may vary widely depending on the specific metal involved and the level of exposure, ranging from fatigue, abdominal pain, and neurological deficits to more severe manifestations like seizures or organ failure. Laboratory findings typically include elevated levels of specific heavy metals in blood tests, and these findings must be interpreted in the context of clinical symptoms and potential exposure history. It is crucial for healthcare providers to assess the patient's occupational and environmental exposure history to determine the source of heavy metal exposure and guide further management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of heavy metals that can be involved
  • Need for comprehensive exposure history
  • Potential overlap with other toxicological conditions
  • Variability in clinical presentation

Audit Risk Factors

  • Inadequate documentation of exposure history
  • Failure to specify the type of heavy metal involved
  • Misinterpretation of lab results
  • Lack of correlation between symptoms and lab findings

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history including occupational and environmental exposures, specific symptoms, and lab results.

Common Clinical Scenarios

Patients presenting with nonspecific symptoms such as fatigue or gastrointestinal complaints, requiring further investigation for heavy metal exposure.

Billing Considerations

Consideration of comorbid conditions that may affect heavy metal metabolism or excretion.

Emergency Medicine

Documentation Requirements

Acute care documentation including immediate symptoms, lab results, and any interventions performed.

Common Clinical Scenarios

Acute presentations of heavy metal poisoning, such as lead or mercury toxicity, requiring rapid assessment and treatment.

Billing Considerations

Timeliness of documentation is critical in emergency settings to ensure appropriate coding and billing.

Coding Guidelines

Inclusion Criteria

Use R78.7 When
  • Follow official ICD
  • CM coding guidelines, ensuring that the diagnosis is supported by clinical documentation and laboratory findings
  • Document the specific heavy metal involved when possible

Exclusion Criteria

Do NOT use R78.7 When
No specific exclusions found.

Related CPT Codes

83655CPT Code

Lead, blood

Clinical Scenario

Used when testing for lead levels in patients suspected of lead exposure.

Documentation Requirements

Document the reason for testing and any relevant exposure history.

Specialty Considerations

Internal medicine and pediatrics often order this test for at-risk populations.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions related to heavy metal exposure, improving the ability to track and manage these cases effectively.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions related to heavy metal exposure, improving the ability to track and manage these cases effectively.

Reimbursement & Billing Impact

reimbursement and compliance.

Resources

Clinical References

  • •
    CDC - Heavy Metals Toxicity

Coding & Billing References

  • •
    CDC - Heavy Metals Toxicity

Frequently Asked Questions

What symptoms indicate the need for testing heavy metal levels?

Symptoms such as unexplained fatigue, neurological changes, gastrointestinal issues, or a known history of exposure to heavy metals warrant testing for abnormal levels.