What is Lactic Acidosis?
A high lactic acid value means lactic acidosis, which can be caused by: Severe loss of water from the blood (dehydration). Blood problems, such as severe anemia or leukemia. Liver disease or liver damage that prevents the liver from breaking down lactic acid in the blood.
Objectives:
2 - Acidosis is a sample topic from the ICD-10-CM. To view other topics, please log in or purchase a subscription. ICD-10-CM 2022 Coding Guide™ from Unbound Medicine.
Lactic acidosis occurs when lactic acid production exceeds lactic acid clearance. The increase in lactate production is usually caused by impaired tissue oxygenation, either from decreased oxygen delivery or a defect in mitochondrial oxygen utilization. (See "Approach to the adult with metabolic acidosis".)
ICD-10 code E87. 2 for Acidosis is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .
E87. 2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E87.
Lactic acidosis is a high anion gap metabolic acidosis Metabolic Acidosis Metabolic acidosis is primary reduction in bicarbonate (HCO3−), typically with compensatory reduction in carbon dioxide partial pressure (Pco2); pH may be markedly low or slightly... read more due to elevated blood lactate.
Lactate acidosis is a common finding in diabetic ketoacidosis (DKA). Lactate acidosis in DKA is multifactorial in aetiology— anaerobic glycolysis due to inadequate tissue perfusion and oxygenation as well as the metabolic derangements itself present in DKA might contribute to the elevated lactate levels.
Lactic acidosis shares the ICD-10-CM code, E87. 2, Acidosis, with other causes of acidosis, respiratory or metabolic.
ICD-10-CM Code for Elevation of levels of lactic acid dehydrogenase [LDH] R74. 02.
From a coding standpoint, ICD-10 code A41. x series do not have Excludes 1 notes for acidosis and the acidosis E codes do not have Excludes 1 notes for sepsis.
Lactic acidosis is associated with multiple organ failure and need for ventilator support in patients with severe hemorrhage from trauma.
Metabolic acidosis develops when too much acid is produced in the body. It can also occur when the kidneys cannot remove enough acid from the body.
ICD-10-CM Diagnosis Code P74 P74.
The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. A state due to excess retention of carbon dioxide in the body. Acid base imbalance resulting from an accumulation of carbon dioxide secondary to hypoventilation.
A disorder characterized by abnormally high acidity (high hydrogen-ion concentration) of the blood and other body tissues. A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up.
It may occur spontaneously or in association with diseases such as diabetes mellitus, leukemia, or liver failure. Acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized; may occur spontaneously or in association with diseases such as diabetes mellitus, leukemia, or liver failure.
A condition in which the blood is too acidic. It may be caused by severe illness or sepsis (bacteria in the bloodstream). A disorder characterized by abnormally high acidity (high hydrogen-ion concentration) of the blood and other body tissues. A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. A state due to excess retention of carbon dioxide in the body. Acid base imbalance resulting from an accumulation of carbon dioxide secondary to hypoventilation. Acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized. It may occur spontaneously or in association with diseases such as diabetes mellitus, leukemia, or liver failure. Acidosis caused by accumulation of lactic acid more rapidly than it can be metabolized; may occur spontaneously or in association with diseases such as diabetes mellitus, leukemia, or liver failure. An abnormal increase in the acidity of the body's fluids An abnormally high acidity (excess hydrogen-ion concentration) of the blood and other body tissues. An abnormally high acidity of the blood and other body tissues. Acidosis can be either respiratory or metabolic. Excess retention of carbon dioxide in the body resulting from ventilatory impairment. Increased acidity in the blood secondary to acid base imbalance. Causes include diabetes, kidney failure and shock. Metabolic acidosis characterized by the accumulation of lactate in the body. It is caused by tissue hypoxia. Pathologic condition resulting from accumulation of acid or depletion of the alkaline reserve (bicarbonate) content of the blood and body tissues, and characterized by an increase in hydrogen ion concentration (decrease in ph). Respi Continue reading >>
N00-N99 Diseases of the genitourinary system N25-N29 Other disorders of kidney and ureter N25- Disorders resulting from impaired renal tubular function Other disorders resulting from impaired renal tubular function N25.89 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Short description: Oth disorders resulting from impaired renal tubular function The 2018 edition of ICD-10-CM N25.89 became effective on October 1, 2017. This is the American ICD-10-CM version of N25.89 - other international versions of ICD-10 N25.89 may differ. The following code (s) above N25.89 contain annotation back-references In this context, annotation back-references refer to codes that contain: certain conditions originating in the perinatal period ( P04 - P96 ) certain infectious and parasitic diseases ( A00-B99 ) complications of pregnancy, childbirth and the puerperium ( O00-O9A ) congenital malformations, deformations and chromosomal abnormalities ( Q00-Q99 ) endocrine, nutritional and metabolic diseases ( E00 - E88 ) injury, poisoning and certain other consequences of external causes ( S00-T88 ) symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified ( R00 - R94 ) disorders of kidney and ureter with urolithiasis ( N20-N23 ) Hyperkalemic distal renal tubular acidosis Metabolic acidosis, nag, acidifying salts Metabolic acidosis, normal anion gap (nag) A group of genetic disorders of the kidney tubules characterized by the accumulation of metabolically produced acids with elevated plasma chloride, hyperchloremic metabolic acidosis. Defective renal acidification of urine (proximal tubules) or low renal acid excretion (distal tubules) can lead to complications such as hypokalemia, hypercalcinuria with nephr Continue reading >>
Lactic acidosis is typically the result of an underlying acute or chronic medical condition, medication, or poisoning. The symptoms are generally attributable to these underlying causes, but may include nausea, vomiting, rapid deep breathing, and generalised weakness. The diagnosis is made on biochemical analysis of blood (often initially on arterial blood gas samples), and once confirmed, generally prompts an investigation to establish the underlying cause to treat the acidosis. In some situations, hemofiltration (purification of the blood) is temporarily required. In rare chronic forms of lactic acidosis caused by mitochondrial disease, a specific diet or dichloroacetate may be used. The prognosis of lactic acidosis depends largely on the underlying cause; in some situations (such as severe infections), it indicates an increased risk of death. Classification The Cohen-Woods classification categorizes causes of lactic acidosis as: [1] Type A: Decreased tissue oxygenation (e.g., from decreased blood flow) Type B B1: Underlying diseases (sometimes causing type A) B2: Medication or intoxication B3: Inborn error of metabolism Signs and symptoms Lactic acidosis is commonly found in people who are unwell, such as those with severe heart and/or lung disease, a severe infection with sepsis, the systemic inflammatory response syndrome due to another cause, severe physical trauma, or severe depletion of body fluids. [2] Symptoms in humans include all those of typical m Continue reading >>
Lactic acidosis, on the other hand, is associated with major metabolic dysregulation, tissue hypoperfusion, the effects of certain drugs or toxins, and congenital abnormalities in carbohydrate metabolism. It also occurs as a result on markedly increased transient metabolic demand (e.g., post seizure lactic acidosis).
Lactic acidosis results from overproduction of lactate, decreased metabolism of lactate, or both. Type A lactic acidosis, the most serious form, occurs when lactic acid is overproduced in ischemic tissue—as a byproduct of anaerobic generation of adenosine triphosphate (ATP from pyruvate) during oxygen deficit via anerobic glycolysis. ...
In light of all this, your question has multiple answers: 1 From a coding standpoint, ICD-10 code A41.x series do not have Excludes 1 notes for acidosis and the acidosis E codes do not have Excludes 1 notes for sepsis. From a strictly coding standpoint, these codes may be reported together. 2 From a clinical standpoint, any patient with severe sepsis would be expected to have elevated lactate levels, they would not, however, be expected to always have a large anion gap and persistent levels of lactate > 5mmol/l after hydration. In fact, such a patient would be considered by many definitions (Sepsis-3 included) to be in septic shock.
The lactate exits the cells and is transported to the liver, where it is oxidized back to pyruvate and ultimately converted to glucose via the Cori cycle. However, all tissues can use lactate as an energy source, as it can be converted quickly back to pyruvate and enter into the Krebs cycle.
Since respiratory failure can be hypoxic, hypercapnic, or both, acidosis is not an integral portion of the ICD-10 code for unspecified respiratory failure, but it would be an integral part of the ICD-10 code for hypercap nic respiratory failure.
If the lactic acidosis is due to an unrelated event in tandem with sepsis such as respiratory failure, severe anemia, asphyxia, limb ischemia, poisoning, hemorrhage, alcohol, etc., then it would be separately reportable as a “multifactorial” metabolic event, but only if documented as such.