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#1
02-01-2012, 10:44 AM
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G6pd
What is the correct ICD-9 code to use for G6PD (Glucose-6-phosphate dehydrogenase deficiency)?
Using deficiency as the main term in the ICD-9 CM index , there is a subterm Glucose-6-phosphate dehydrogenase anemia , code 282.2. anemias due to disorders of glutathione metabolism. This code does not seem accurate when there is no documentation of an anemia. there is also a subterm enzymes, circulating NEC code 277.6 other deficiencies of circulating enzymes This code may not be accurate because glucose-6-phosphate dehydrogenase is considered an enzyme but it is not described as a circulating enzyme Considering the narrative for code 282.2 anemias due to disorders of glutathione metabolism, should the main term be disorder , subterm metabolism NEC, code 277.9 unspecified disorder of metabolism Thank you for any assistance you can give. 
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#2
02-01-2012, 10:54 AM
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Quote:
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Brandi Tadlock, CPC, CPC-P, CPMA, CPCO 
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#4
02-01-2012, 11:14 AM
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Quote:
http://emedicine.medscape.com/article/119184-overview http://emedicine.medscape.com/articl...overview#a0104 I imagine that G6PD deficiency normally results in anemia, for it to be designated that way in the ICD-9. The relationship may be implied, even when it's not separately documented. But, don't quote me on that...If I come across anything more conclusive, I'll let you know. 
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Brandi Tadlock, CPC, CPC-P, CPMA, CPCO
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#5
02-01-2012, 11:27 AM
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These were educational...
http://labtestsonline.org/understand.../g6pd/tab/test (info about the test itself)
http://www.wikidoc.org/index.php/Glu...ase_deficiency (info about the condition) "Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive hereditary disease featuring abnormally low levels of the G6PD enzyme, which plays an important role in red blood cell function. Individuals with the disease may exhibit non-immune hemolytic anemia in response to a number of causes. It is closely linked to favism, a disorder characterized by a hemolytic reaction to consumption of broad beans, with a name derived from the Italian name of the broad bean (fava). Sometimes the name, favism, is alternatively used to refer to the enzyme deficiency as a whole. Epidemiology G6PDD is said to be the most common enzyme deficiency disease in the world, affecting approximately 400,000,000 people globally.[1] A side effect of this disease is that it confers protection against malaria, in particular the form of malaria caused by Plasmodium falciparum, the most deadly form of malaria. A similar relationship exists between malaria and sickle-cell disease. An explanation is that cells infected with the Plasmodium parasite are cleared more rapidly by the spleen. This phenomenon might give G6PD deficiency carriers an evolutionary advantage. ClassificationThere are four forms of G6PD: 1.Hereditary nonspherocytic hemolytic anemia 2.Severe deficiency 3.Mild deficiency 4.Non-deficient variant Pathophysiology Glucose-6-phosphate dehydrogenase (G6PD) is an enzyme in the pentose phosphate pathway, a metabolic pathway that supplies reducing energy to cells (most notably erythrocytes) by maintaining the level of the co-enzyme nicotinamide adenine dinucleotide phosphate (NADPH). The NADPH in turn maintains the level of glutathione in these cells that helps protect the red blood cells against oxidative damage. G6PD converts glucose-6-phosphate into 6-phosphoglucono-δ-lactone and is the rate-limiting enzyme of the pentose phosphate pathway. Patients with G6PD deficiency are at risk of hemolytic anemia in states of oxidative stress. This can be in severe infection, medication and certain foods. Broad beans contain high levels of vicine, divicine, convicine and isouramil — all are oxidants. " Well, I learned something today! 
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Brandi Tadlock, CPC, CPC-P, CPMA, CPCO
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