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v1.0.0
ICD-10 Guide
ICD-10 CodesR79.1

R79.1

Abnormal coagulation profile

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

Code Description

ICD-10 R79.1 is a billable code used to indicate a diagnosis of abnormal coagulation profile.

Key Diagnostic Point:

An abnormal coagulation profile indicates deviations from normal coagulation parameters, which can manifest as prolonged bleeding times, abnormal clotting factors, or unexpected results in coagulation tests such as PT (Prothrombin Time), aPTT (Activated Partial Thromboplastin Time), and INR (International Normalized Ratio). These abnormalities can arise from various underlying conditions, including liver disease, vitamin K deficiency, anticoagulant therapy, or inherited coagulation disorders. Clinically, patients may present with symptoms such as easy bruising, excessive bleeding from minor cuts, or spontaneous bleeding episodes. Laboratory findings may reveal prolonged PT or aPTT, low platelet counts, or abnormal levels of specific clotting factors. Accurate interpretation of these results is crucial for diagnosing and managing conditions that affect hemostasis, and it often requires correlation with clinical findings and patient history.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to abnormal results
  • Need for correlation with clinical symptoms and history
  • Potential for misinterpretation of lab results
  • Variability in laboratory reference ranges

Audit Risk Factors

  • Inadequate documentation of clinical correlation
  • Failure to specify the underlying cause of the abnormality
  • Misuse of the code in the absence of lab results
  • Inconsistent use of related codes

Specialty Focus

Medical Specialties

Internal Medicine

Documentation Requirements

Detailed patient history, including medications, family history of bleeding disorders, and any recent surgeries or trauma.

Common Clinical Scenarios

Patients presenting with unexplained bruising, prolonged bleeding after procedures, or abnormal lab results during routine check-ups.

Billing Considerations

Ensure that all relevant lab results are included in the documentation, and specify any anticoagulant therapy that may affect coagulation.

Emergency Medicine

Documentation Requirements

Immediate documentation of presenting symptoms, lab results, and any interventions performed.

Common Clinical Scenarios

Patients with acute bleeding episodes, trauma cases, or those presenting with signs of a stroke.

Billing Considerations

Rapid assessment and documentation are crucial; ensure that any anticoagulant use is noted.

Coding Guidelines

Inclusion Criteria

Use R79.1 When
  • Follow official ICD
  • CM guidelines for coding symptoms and abnormal findings
  • Ensure that the code is used in conjunction with any underlying conditions or treatments that may explain the abnormal coagulation profile

Exclusion Criteria

Do NOT use R79.1 When
No specific exclusions found.

Related CPT Codes

85610CPT Code

Prothrombin time (PT)

Clinical Scenario

Used when evaluating patients with suspected coagulation disorders.

Documentation Requirements

Document the indication for the test and any relevant clinical history.

Specialty Considerations

Ensure that the test results are interpreted in the context of the patient's overall clinical picture.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of abnormal coagulation profiles, improving the ability to capture the complexity of these conditions and their management.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of abnormal coagulation profiles, improving the ability to capture the complexity of these conditions and their management.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of abnormal coagulation profiles, improving the ability to capture the complexity of these conditions and their management.

Resources

Clinical References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Coding & Billing References

  • •
    ICD-10-CM Official Guidelines for Coding and Reporting

Frequently Asked Questions

What should be documented to support the use of R79.1?

Documentation should include the patient's clinical symptoms, relevant lab results, any underlying conditions, and the rationale for testing. This ensures that the coding is accurate and justifiable.