Lactic Acidosis ICD-10-CM Codes

What are Lactic Acidosis ICD-10-CM Codes?

Lactic acidosis is a pathologic condition resulting from the accumulation of lactic acid in the body, typically due to acute metabolic acidosis or impaired cellular respiration. It can be triggered by underlying metabolic diseases, diabetes, heart failure, sepsis, and various metabolic disorders. In the ICD-10-CM system, several diagnosis codes are used to classify lactic acidosis, metabolic acidosis, and associated acid-base imbalances for documentation and billing purposes.

Each of the following ICD-10 codes helps healthcare providers accurately capture cases of lactic acidosis, unspecified acidosis, and acid-base disturbances in medical records:

• E87.21 – Acute metabolic acidosis: This code is assigned for cases of acute metabolic acidosis, a condition involving a rapid buildup of metabolic acid in the bloodstream. It is often caused by lactic acid accumulation, diabetic ketoacidosis, or acid-base imbalance due to severe illness. This includes conditions such as respiratory failure with hypercapnia, heart failure, and diabetes.
• E87.20 – Acidosis, unspecified: Used when the cause or type of acidosis is not clearly defined, this code covers unspecified lactic acidosis and lactic acidosis NOS. It is a billable non-specific code and may apply when a full diagnosis is pending, when the provider uses general terms, or when the acid accumulation does not fit into a more specific category.
• R74.0 – Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase (LDH): This code documents nonspecific elevation in enzyme levels, such as LDH, which may signal lactic acid buildup in the absence of clear clinical context. While not directly diagnostic of lactic acidosis, it may support the presence of metabolic disorders or lactic acidosis when correlated with symptoms or lab findings.
• E87.4 – Mixed disorder of acid-base balance: Used for patients with combined acid-base disorders, this code includes situations where metabolic acid buildup coexists with respiratory failure or other forms of acidosis. It reflects complex clinical presentations, such as metabolic acidosis NOS paired with carbon dioxide retention or other acidosis.

Which Lactic Acidosis ICD-10-CM Codes are billable?

Yes, all the ICD-10-CM codes listed—E87.21, E87.20, E87.4, and R74.0—are billable codes. While E87.21 and E87.4 offer greater specificity, E87.20 is a billable non-specific code often used when clinical details are limited. Ensure documentation includes the underlying cause when available. These codes also support claims when converted to parent code groups for medical necessity or coding audits.

Clinical information

Lactic acidosis is characterized by excess lactic acid buildup in the blood due to an imbalance in cellular respiration.

• Causes of lactic acidosis include heart failure, diabetes, liver disease, sepsis, certain drugs, and strenuous exercise.
• Symptoms of lactic acidosis include shortness of breath, muscle pain, nausea, vomiting, confusion, and seizures.
• Treatment depends on the underlying cause and may involve correcting problems, administering fluids, or providing breathing support.
• Prompt treatment typically leads to full recovery, but if left untreated, lactic acidosis can be fatal.
• Lactic acidosis results from an imbalance in the production and removal of lactic acid during cellular respiration.
• Underlying conditions like heart failure, diabetes, liver disease, sepsis, certain medications, and intense exercise can contribute to lactic acidosis.
• Common symptoms include shortness of breath, muscle pain, nausea, vomiting, confusion, and seizures.
• Immediate medical attention is crucial to prevent potential complications, as untreated lactic acidosis can be life-threatening.
• Treatment strategies focus on addressing the root cause, which may involve infection treatment, medication adjustments, IV fluids, or respiratory support.
• Timely intervention leads to positive outcomes, but neglecting treatment can result in severe consequences, including fatal outcomes.

Synonyms include:

• Lactic acidosis metabolic
• Metabolic acidosis due to lactic acid
• Systemic lactic acidosis
• Lactic acidemia
• Lactic acid poisoning