Labcorp provides ICD-10 coding resources that may be helpful for your office. Labcorp continues to rely on the ordering physician to provide diagnostic information for the individual patient.
Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC; 070789: Free Valproic Acid (Depakote) 4087-3: 070790: Free Valproic Acid (Depakote) ug/mL: 4087-3
Valproic acid overdose ICD-10-CM T42.6X1A is grouped within Diagnostic Related Group (s) (MS-DRG v38.0): 917 Poisoning and toxic effects of drugs with mcc 918 Poisoning and toxic effects of drugs without mcc
2018/2019 ICD-10-CM Diagnosis Code R89.2. Abnormal level of other drugs, medicaments and biological substances in specimens from other organs, systems and tissues. R89.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
From ICD-10: For encounters for routine laboratory/radiology testing in the absence of any signs, symptoms, or associated diagnosis, assign Z01. 89, Encounter for other specified special examinations.
LOINC MapOrder CodeOrder Code NameResult LOINC070789Free Valproic Acid (Depakote)4087-3
LOINC MapOrder CodeOrder Code NameResult Code Name007260Valproic Acid (Depakote)(R),SValproic Acid (Depakote)(R),S
A closely related medication, Depakene (valproic acid), comes in capsule and liquid form. Another variety of valproic acid, Stavzor, is no longer manufactured. In 2008, the FDA approved the first generic version of Depakote. Collectively, these medications are known as valproate products.
ICD-10-CM Diagnosis Code E71 E71.
It is recommended that trough levels for the DR version be drawn immediately prior to the morning dose, assuming a twice-daily dosing strategy. For once-daily divalproex ER regimens, the ideal time to draw serum levels is immediately prior to the next scheduled dose.
Depakote levels are routinely checked with blood tests to make sure you have neither too little nor too much in your system. Too little will render it ineffective while too much may be toxic.
The valproic acid test is used to measure and monitor the amount of valproic acid in the blood and determine whether the drug concentration is within the therapeutic range. The prescribed dose of the drug may be adjusted up or down depending on the results of the blood test.
About Depakote. Depakote is one of the first generation of a class of medications called antiepileptic drugs (AEDs). Depakote is used to treat complex partial seizures, simple and complex absence seizures, as well as acute manic symptoms in patients with bipolar disorder.
The biggest difference between Depakene and Depakote lies in how the body breaks them down. Depakene is made of valproic acid only. Depakote is made by combining valproic acid and sodium valproate (another similar chemical) in a lab.
AcidShort-chain fatty acidSodium valproate/Classification
Available in two strengths, Depakote ER contains the same active ingredient as Depakote Delayed-Release Tablets but it is designed to slowly deliver the medication over a 24-hour period. This means that Depakote ER only has to be taken once a day.
Valproate is absorbed rapidly and completely following oral administration; peak plasma concentrations usually occur within two hours after ingestion of liquid preparations and three to four hours after ingestion of the delayed-release tablet preparation, divalproex sodium, which contains sodium valproate and valproic acid.
The half-life of valproate in adults is 12 to 16 hours. In epileptic patients receiving polytherapy, the half-life is approximately nine hours, although five hours has also been reported. The half-lives in school-age children and young adolescents are well within the range of values in adults.
Although some clinicians prefer valproate for absence seizures, the American Academy of Pediatrics (Committee on Drugs, 1982) recommended that it be reserved for use when therapeutic failure or intolerance to ethosuximide occurs, because valproate causes rare but potentially fatal hepatotoxicity.
Valproate is the drug of choice in myoclonic epilepsy, with or without generalized tonic-clonic seizures, including juvenile myoclonic epilepsy of Janz, that begins in adolescence or early adulthood. Photosensitive myoclonus is usually easily controlled.
One unsaturated metabolite, 2-n-propyl-4-pente noic acid (4-ene-VPA), has been proposed as a key hepatotoxic metabolite. The formation of this metabolite is increased by concomitant use of phenytoin, phenobarbital, carbamazepine, and other drugs that induce cytochrome P450.
Use. Valproate (valproic acid; divalproex sodium, a compound containing sodium valproate and valproic acid) controls absence, myoclonic, and tonic-clonic seizures in generalized, idiopathic, and symptomatic epilepsy. It is most useful in typical absence seizures. Valproate is as effective as ethosuximide in patients with absence seizures alone ...
The ICD-10-CM code set replaced the ICD-9-CM code set on October 1, 2015, for covered entities under the Health Insurance Portability and Accountability Act (HIPAA). ICD-10-CM uses different formatting and an expanded character set.
AAPC is the country’s largest coding training and credentialing organization for the business side of health care. Their certified members in medical coding, medical billing, medical auditing, compliance, and practice management represent the highest level of expertise in the industry.
Carbamazepine can induce the hepatic enzymes CYP3A4, CYP1A2, and CYP2C9, resulting in decreased serum levels of many drugs (eg, alprazolam, clozapine, diazepam, haloperidol, risperidone, and tricyclic antidepressants). 2.
Many clinicians consider carbamazepine a drug of choice for initial therapy in idiopathic and symptomatic localization-related epilepsies, especially in children and women. This drug is increasingly preferred to phenobarbital in pediatric patients because it has less effect on cognition and behavior.
Use secondary code (s) from Chapter 20, External causes of morbidity, to indicate cause of injury. Codes within the T section that include the external cause do not require an additional external cause code.
Type 2 Excludes. drug dependence and related mental and behavioral disorders due to psychoactive substance use ( F10.-. - F19.-) Poisoning by, adverse effect of and underdosing of antiepileptic, sedative- hypnotic and antiparkinsonism drugs.
T42.6 Poisoning by, adverse effect of and underdosing of other antiepileptic and sedative-hypnotic drugs. T42.6X Poisoning by, adverse effect of and underdosing of other antiepileptic and sedative-hypnotic drugs. T42.6X1 Poisoning by other antiepileptic and sedative-hypnotic drugs, accidental (unintentional)
Peak levels should be ordered using test 070327. Trough levels should be ordered using test 070328. Peak and trough levels may be ordered together as a profile on the same request form using test 717314. Please label tubes appropriately as “peak” and “trough.”
Turnaround time is defined as the usual number of days from the date of pickup of a specimen for testing to when the result is released to the ordering provider. In some cases, additional time should be allowed for additional confirmatory or additional reflex tests. Testing schedules may vary.
Red-top tube, lavender-top (K2- or K3- EDTA) tube, or green-top (heparin) tube. Do not use a gel-barrier tube. The use of gel-barrier tubes is not recommended due to slow absorption of the drug by the gel. Depending on the specimen volume and storage time, the decrease in drug level due to absorption may be clinically significant.
Transfer separated serum or plasma to a plastic transport tube. Trough concentrations should be monitored. The trough sample is drawn immediately prior to the next dose.