Hyperkalemia ICD-10-CM Codes

What ICD-10 codes are used for hyperkalemia?

Hyperkalemia, a potentially life-threatening condition with too much potassium in the blood, is represented by several ICD-10-CM codes. The following are frequently used hyperkalemia ICD codes:

• E87.5: Hyperkalemia. This code is generally used when a patient has high potassium levels confirmed by laboratory testing.
• I12.0: Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end-stage renal disease. Hyperkalemia can be a complication of this condition.
• E11.29: Type 2 diabetes mellitus with other diabetic kidney complications. Hyperkalemia can occur due to kidney dysfunction caused by diabetes.
• E13.21: Other specified diabetes mellitus with diabetic nephropathy. Hyperkalemia can be a secondary condition in these patients.
• I15.1: Hypertension secondary to other renal disorders. This condition can lead to hyperkalemia due to kidney failure.
• N25.81: Secondary hyperparathyroidism of renal origin. The condition can impair the body's ability to regulate potassium levels, resulting in hyperkalemia.
• N17.9: Acute kidney failure, unspecified. This code is used when a patient experiences a sudden decline in kidney function. Hyperkalemia may occur as a secondary complication due to impaired potassium excretion.
• N18.9: Chronic kidney disease, unspecified. This code applies to cases of chronic kidney disease (CKD) where the stage is not specified. Since hyperkalemia is a common consequence of reduced renal clearance, it should be coded when documented.
• T50.B95A: Adverse effect of potassium-sparing diuretics, initial encounter. Used when hyperkalemia results from a known adverse reaction to medications such as spironolactone or amiloride.
• T45.1X5A: Adverse effect of anticoagulants, initial encounter. This code is appropriate when hyperkalemia is due to the adverse effects of anticoagulants like heparin, which can suppress aldosterone and disrupt potassium balance.

Which hyperkalemia ICD codes are billable?

Yes, all of the following ICD-10-CM codes are billable. However, note that T-codes (e.g., T50.B95A and T45.1X5A) represent external causes (such as adverse drug effects) and must be paired with a diagnosis code that describes the clinical condition or manifestation—such as E87.5 (Hyperkalemia)—to provide a complete and valid claim.

Clinical information

• Hyperkalemia refers to an abnormally high potassium concentration in the blood, typically defined as serum potassium levels above 5.0 mmol/L. While not a disease itself, hyperkalemia is a critical electrolyte imbalance that can lead to life-threatening complications, most notably cardiac arrhythmias and sudden cardiac arrest.
• Potassium is essential for maintaining nerve transmission, muscle contraction, and especially the electrical activity of the heart. Elevated potassium disrupts this balance, potentially producing elevated T waves on ECG, slowed conduction, bradycardia, or ventricular fibrillation in severe cases.
• Additional contributors to hyperkalemia include metabolic acidosis, which shifts potassium from the intracellular to the extracellular space, and heart failure, where impaired renal perfusion leads to reduced potassium clearance. Various metabolic diseases, particularly diabetes mellitus, can impair kidney function and contribute to elevated potassium levels.
• Certain medications, including angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), and potassium-sparing diuretics, are also common culprits, as they interfere with potassium excretion.
• Hyperkalemia is often asymptomatic and discovered incidentally during routine blood tests or investigations for other medical conditions. When symptoms do occur, they may include muscle weakness or flaccid paralysis, numbness or tingling (paresthesia), palpitations or irregular heartbeat, fatigue or generalised malaise, and bradycardia.
• Management of hyperkalemia depends on its severity, presenting symptoms, and underlying cause. Mild cases may only require dietary potassium restriction and adjustment of medications, such as discontinuing angiotensin-converting enzyme (ACE) inhibitors if they are contributing to the elevated potassium levels.
• Moderate to severe hyperkalemia requires urgent medical intervention to prevent life-threatening cardiac complications. This may include administering calcium gluconate to stabilise cardiac membranes, using insulin with glucose, beta-agonists, or sodium bicarbonate to shift potassium into cells, and employing loop diuretics, cation exchange resins, or dialysis to actively remove excess potassium from the body.

Synonyms include

• High serum potassium
• High blood potassium
• Hyperpotassemia
• Increased potassium
• High K+ levels