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E80.4
ICD-10-CM
Gilbert's Syndrome

Learn about Gilbert's Syndrome diagnosis, including ICD-10 code R17 and related SNOMED CT codes. Find information on bilirubin levels, hyperbilirubinemia, and the UGT1A1 gene variant. Explore clinical documentation best practices for Gilbert Syndrome diagnosis and management, along with differential diagnosis considerations. Understand the genetic basis and typically benign nature of this inherited liver condition. Access resources for healthcare professionals, including diagnostic criteria and patient education materials related to Gilbert Syndrome.

Also known as

Gilbert syndrome
Inherited disorder of bilirubin metabolism

Diagnosis Snapshot

Key Facts
  • Definition : Mild genetic disorder causing intermittent jaundice due to elevated unconjugated bilirubin.
  • Clinical Signs : Usually asymptomatic, sometimes mild jaundice, fatigue, abdominal discomfort.
  • Common Settings : Primary care, routine blood tests, gastroenterology (if symptoms persist).

Related ICD-10 Code Ranges

Complete code families applicable to AAPC E80.4 Coding
E80.0

Disorders of bilirubin metabolism

Gilbert's syndrome is a mild liver condition causing elevated bilirubin levels.

K70-K77

Diseases of liver

This range includes various liver conditions, though Gilbert's is specifically E80.0.

R17

Jaundice

Gilbert's can sometimes cause mild jaundice due to increased bilirubin.

Code Comparison

Related Codes Comparison

When to use each related code

Description
Mild unconjugated hyperbilirubinemia
Severe unconjugated hyperbilirubinemia
Dubin-Johnson Syndrome

Documentation Best Practices

Documentation Checklist
  • Gilbert's Syndrome diagnosis documented
  • Elevated unconjugated bilirubin noted
  • Normal liver function tests (LFTs) documented
  • Exclude other hyperbilirubinemia causes
  • Genetic testing (UGT1A1) optional

Mitigation Tips

Best Practices
  • Document elevated bilirubin, family history, exclude other liver disease (ICD-10: R17, Z82.4)
  • Order targeted labs: unconjugated bilirubin, LDH, CBC. Avoid extensive, costly workups (CPT: 82565, 85025, 85027)
  • CDI: Query 'Gilbert's' vs. other hyperbilirubinemia. Ensure accurate coding for reimbursement (ICD-10: E80.4)
  • Educate patients: benign condition, lifestyle factors (fasting, stress) can trigger jaundice. No treatment needed.
  • Regular monitoring unnecessary. Intermittent bilirubin checks suffice. Avoid overtreatment, enhance compliance.

Clinical Decision Support

Checklist
  • Elevated unconjugated bilirubin (UCB)
  • Normal liver enzymes (ALT, AST, ALP)
  • Negative hemolysis workup (CBC, haptoglobin)
  • Consider genetic testing (UGT1A1)
  • Exclude other liver disorders

Reimbursement and Quality Metrics

Impact Summary
  • Gilbert's Syndrome: ICD-10-CM code Z74.89, impacting reimbursement through accurate diagnosis coding.
  • Medical billing for Gilbert's Syndrome requires specificity for optimal reimbursement and reduced claim denials.
  • Coding accuracy with SNOMED CT 16623001 ensures appropriate hospital reporting and quality metrics.
  • Impact: improved data integrity for Gilbert's Syndrome facilitates better patient care and resource allocation.

Streamline Your Medical Coding

Let S10.AI help you select the most accurate ICD-10 codes for . Our AI-powered assistant ensures compliance and reduces coding errors.

Quick Tips

Practical Coding Tips
  • Code primary UGT1A1 mutation
  • Document bilirubin levels
  • Exclude hemolysis, other liver disease
  • Query physician if diagnosis unclear
  • SNOMED CT: Gilbert's syndrome

Documentation Templates

Patient presents with intermittent episodes of mild jaundice, often triggered by stressors such as fasting, illness, or strenuous exercise.  The patient denies abdominal pain, pruritus, or changes in stool color.  Physical examination reveals mild scleral icterus.  Laboratory findings demonstrate an elevated unconjugated bilirubin level, with normal conjugated bilirubin, liver enzymes (AST, ALT, ALP), and complete blood count (CBC).  These findings are consistent with the diagnostic criteria for Gilbert's Syndrome.  Given the patient's history and laboratory results, a diagnosis of Gilbert's Syndrome (ICD-10-CM code E80.4) is established.  No specific treatment is indicated for Gilbert's Syndrome, as it is a benign condition.  Patient education regarding the nature of the syndrome, its hereditary component, and the typically harmless fluctuations in bilirubin levels was provided.  Reassurance was given regarding the excellent prognosis and lack of long-term complications.  Follow-up is not routinely required, but the patient is encouraged to return if new or concerning symptoms develop.  Differential diagnoses considered included hemolytic anemia, hepatitis, and other inherited hyperbilirubinemias, which were ruled out based on the normal CBC and liver enzyme panel.  This diagnosis is supported by the established medical understanding of Gilbert syndrome as a mild, inherited disorder of bilirubin metabolism, characterized by unconjugated hyperbilirubinemia.  The patient's understanding of the condition and lack of significant concerns were documented.  Medical coding for this encounter will include E80.4 reflecting the diagnosis of Gilbert's Syndrome.  The patient was advised on lifestyle modifications, including maintaining adequate hydration and nutrition, to potentially mitigate symptom exacerbations.
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