In this article will learn the following topics: Symptoms, Types of Jaundice, ICD 10 Code for Jaundice, ICD 10 Code for Neonatal Jaundice or Newborn Jaundice, ICD 10 Code for Obstructive Jaundice and its coding guidelines along with examples.
The term Jaundice has come from French word Jaune (means yellow). Jaundice is very common in new born which makes skin and white of the eyes yellow. This yellow colour happens due to excess amount of Bilirubin (yellow pigment formed during normal breakdown of RBC) in blood. In normal body function, liver filters out bilirubin in bile from blood. But amount of bilirubin increases in blood if liver has any problem and not taking bilirubin.
New born jaundice gets cured after few days by exposing to light or sunlight which breaks down bilirubin and liver will start functioning normally. Jaundice in adult needs immediate medical care as it is a sign of an underlying disease such as:
- Inflammation of liver/ Hepatitis
- Inflammation of bile duct
- Alcoholic liver disease
- Obstruction of bile duct
- Hemolytic anemia
- Gilbert’s syndrome
Symptoms and Tests:
Common symptoms of jaundice are yellow skin and white of eyes, dark coloured body fluids (urine and stool). If jaundice along with severe abdominal pain, blood vomit, blood in stool, change in mental function, fever or tendency to bleed easily are cause of concern.
Physician diagnose jaundice by doing physical exam to check the skin and eye colour change, liver function test, coagulation studies, ultrasound, CT, MRI, cholescintigraphy, endoscopic retrograde cholangiopancretography. Sometimes biopsy is done to check for cancer cells.
Types of Jaundice:
There are mainly 3 types of jaundice – Prehepatic, hepatic, posthepatic.
Prehepatic – More amount of bilirubin is produced when RBC lysis exceeds. This is more than the liver capacity. Causes of prehepatic jaundice are thalassemia, sickle cell anemia, autoimmune disease and transfusion
Hepatic – This happens due to liver dysfunction and diseases like hepatitis, cirrhosis, congenital disorders, cancer and drugs.
Posthepatic – It is also called obstructive due to blockage of flow of bile into intestine.
ICD 10 Codes for Jaundice and Coding guidelines:
ICD 10 Codes for jaundice are located in different chapters in ICD book. ICD 10 Code for Neonatal jaundice are found in chapter 16 – conditions originating in perinatal period, code range P00 – P96
It is important to see the patient age and cause of jaundice in medical record to code to the highest specificity.
- Unspecified Jaundice in adult should be coded with Dx R17
ICD 10 codes for Neonatal Jaundice or Newborn Jaundice
- These codes are used for new born of age 0 to 28 days old.
- Hyperbilirubinemia in new born should be coded as newborn Jaundice (As per ICD-10 CM index listing).
There are 4 categories of codes for newborn jaundice as per the cause – P55 (hemolytic disease), P57 (kernicterus), P58 (due to other hemolytic reasons) and P59 (Neonatal jaundice from other specified causes)
P55 – RBC breakdown happens at a faster rate in new born and abnormal presence of erythroblasts can be found in the circulation. This can happen due to the incompatibility of the blood groups or Rh factor in newborn and the mother.
|P55.8||Other hemolytic diseases|
|P55.9||Unspecified hemolytic diseases|
P57 – When jaundice is left untreated, number of bilirubin increases and it cause brain damage
|P57.0||Kernicterus caused by isoimmunization|
P58 – Jaundice happens due to RBC breakdown of different reasons
|P58.0||Due to bruising|
|P58.1||Due to bleeding|
|P58.2||Due to infection|
|P58.3||Due to polycythemia|
|P58.41 – P59.42||Due to drugs or toxins transmitted from mother or given to baby|
|P58.5||Due to swallowed maternal food|
|P58.8||Due to other specified hemolysis|
|P58.9||Due to unspecified hemolysis|
P59 – Any other reason for jaundice is categorized here.
|P59.0||Associated with pre-term delivery|
|P59.1||Inpissated bile syndrome|
|P59.20 – P59.29||Jaundice caused from hepatocellular jaundice|
|P59.3||Jaundice caused from breast milk inhibitor|
|P59.8||Jaundice from any other cause|
|P59.9||Jaundice from unspecified cause|
ICD 10 Code for Obstructive Jaundice
- It is caused by blocked pancreatic duct or bile duct
- Obstructive jaundice or regurgitation jaundice guide us to see obstruction bile duct which leads to K83.1
- When jaundice affects larger number of people as epidemic, ICD-10 manual index to Hepatitis A Dx B15.9
- Familial non-hemolytic jaundice is called Gilbert syndrome which is an inborn disease caused by mutated gene. ICD-10 manual index leads to Dx E80.4
Below are few examples on coding Jaundice in newborn and adult.
ICD 10 Codes for Jaundice Example 1:
74 year old Andrea presents to hospital for progressive jaundice, abdominal pain and fever from past 3 days. His medical history includes hypertension and diabetes. His medication list was reviewed and includes lisinopril and insulin. Abdominal exam showed tenderness in right upper quadrant. Vitals noted a temperature of 101 degree and BP of 130/90 mmHg. Skin looks yellow. Lab work up showed bilirubin of 5.4 mg/dL with elevated liver enzymes of AST 231 U/L and ALT 178 U/L. An ERCP (retrograde cholangiopancretography) was performed for further study and it showed bile duct obstruction.
Diagnosis : Obstructive jaundice.
K83.1 – Obstructive jaundice
I10 – Hypertension
E11.9 – DM
Z79.4 – Use of insulin
R10.11 – Abdominal pain RUQ
Note: Obstructive jaundice should be coded to obstruction of bile duct K83.1
ICD 10 Codes for Jaundice Example 2:
Christopher is a 65 year old man who came to clinic with his wife for yellow skin and eyes. He is a diabetic patient and takes metformin daily. His social history was noted for alcoholism (takes whiskey daily). His symptoms include nausea, vomiting and lose of weight from past 1 week. He takes very little food as per his wife. He feels feverish from today morning. His vitals are normal except for fever of 102 degree. Physical examination found yellow skin and nails and epigastric abdominal pain. Urine looks dark coloured. Final clinical impression was mentioned as Jaundice.
R17 – Jaundice
E11.9 – Diabetes
F10.20 – Alcoholism
R63.4 – weight loss
R50.9 – Fever
R10.13 – Epigastric pain
Note: Unspecified jaundice is coded as R17.
ICD 10 Codes for Jaundice Example 3:
A new born baby of 5 days old has brought for a checkup to pediatrician. There is no feeding problem, but the baby is not gaining weight at all. Physician noticed white of eye and skin turned pale yellow. This case was diagnosed as hyperbilirubinemia and weight loss. Physician advised parents to expose the kid to sunlight for 10 min every morning for a week and follow up after that. He told not to expose to sunlight directly, instead hold the baby near a closed window. He explained the case is very mild hence do not need any medical treatment currently.
ICD 10 codes:
P59.9 – Neonatal jaundice
R63.4 – Lose of weight
Note: Hyperbilirubinemia in new born should be coded as jaundice new born as per ICD-10 CM manual index list.