Version 2024
No Valid Principal Dx

2024 ICD-10-CM Diagnosis Code R74.0

Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH]

ICD-10-CM Code:
R74.0
ICD-10 Code for:
Nonspec elev of levels of transamns & lactic acid dehydrgnse
Is Billable?
Not Valid for Submission
Chronic Condition Indicator: [1]
Not chronic
Code Navigator:

Code Classification

  • Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified
    (R00–R99)
    • Abnormal findings on examination of blood, without diagnosis
      (R70-R79)
      • Abnormal serum enzyme levels
        (R74)

R74.0 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [ldh]. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

According to ICD-10-CM guidelines this code should not to be used as a principal diagnosis code when a related definitive diagnosis has been established.

Specific Coding Applicable to Nonspec elev of levels of transamns & lactic acid dehydrgnse

Non-specific codes like R74.0 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for nonspec elev of levels of transamns & lactic acid dehydrgnse:

  • Use R74.01 for Elevation of levels of liver transaminase levels - BILLABLE CODE

  • Use R74.02 for Elevation of levels of lactic acid dehydrogenase [LDH] - BILLABLE CODE

Clinical Classification

Convert R74.0 to ICD-9-CM

  • ICD-9-CM Code: 790.4 - Elev transaminase/ldh

Patient Education


ALT Blood Test

What is an ALT Blood Test?

ALT stands for alanine transaminase. It is an enzyme found mostly in the liver. An ALT test measures the amount of ALT in the blood.

When liver cells are damaged, they release ALT into the bloodstream. High levels of ALT in your blood may be a sign of a liver injury or disease. Some types of liver disease cause high ALT levels before you have symptoms of the disease. So, an ALT blood test may help diagnose certain liver diseases early.

Other names: Alanine aminotransferase (ALT), Serum Glutamic-Pyruvic Transaminase (SGPT), GPT

What is it used for?

An ALT blood test is often part of a routine blood screening to check the health of your liver. The test may also help diagnose or monitor liver problems.

Why do I need an ALT blood test?

Your health care provider may order an ALT blood test, as part of a routine checkup. An ALT test is usually done with a group of other liver function tests that check how well your liver is working. These tests may also be ordered if you have symptoms of liver damage, such as:

  • Nausea and vomiting
  • Lack of appetite
  • Fatigue
  • Weakness
  • Jaundice, a condition that causes your skin and eyes to turn yellow
  • Swelling and/or pain in your abdomen (belly)
  • Swelling in your ankles and legs
  • Dark-colored urine (pee) and/or light-colored stool (poop)
  • Frequent itching

Your provider may also order an ALT blood test if you have a high risk for liver damage because of:

  • A family history of liver disease
  • Alcohol abuse disorder (AUD)
  • Obesity
  • Diabetes
  • Taking certain medicines that can cause liver damage
  • Hepatitis or exposure to hepatitis

What happens during an ALT blood test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for an ALT blood test. But an ALT test is usually ordered with other blood tests. You usually need to fast (not eat or drink) for several hours before these tests. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

An ALT blood test is often done as part of a group of liver function tests. Liver function tests measure several different proteins, substances, and enzymes that show how well your liver is working. Your provider usually compares your ALT results with the results of the other liver tests to evaluate your liver health and to decide if you need other tests to make a diagnosis.

In general, high levels of ALT may be a sign of liver damage from hepatitis, infection, cirrhosis, liver cancer, or other liver diseases. The damage may also be from a lack of blood flow to the liver or certain medicines or poisons.

If your results show you have a high level of ALT, it doesn't always mean that you have a medical condition that needs treatment. Many things can affect your results, such as your age, sex, certain medicines and dietary supplements, intense exercise, how much you weigh, and having a menstrual period.

To learn what your results mean, talk with your provider. And be sure tell your provider about all the medicines and supplements you take.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about an ALT blood test?

ALT test results may help tell the difference between damage from acute (sudden) liver problems and chronic (long-term) liver problems. But the amount of ALT in your blood isn't related to how much your liver may be damaged.

ALT used to be called SGPT, which stands for serum glutamic-pyruvic transaminase. The ALT blood test was formerly known as the SGPT test.

References

  1. American Liver Foundation. [Internet]. New York: American Liver Foundation; c2022. . Diagnosing Liver Disease – Liver Biopsy and Liver Function Tests; [updated 2020 Feb 17; cited 2022 Feb 16]; [about 3 screens]. Available from: https://liverfoundation.org/for-patients/about-the-liver/diagnosing-liver-disease/
  2. Hinkle J, Cheever K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Alanine Aminotransferase (ALT); p. 31.
  3. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; 2022. Elevated liver enzymes; [cited 2022 Feb 24]; [about 3 screens]. Available from: https://www.mayoclinic.org/symptoms/elevated-liver-enzymes/basics/definition/sym-20050830
  4. Mayo Clinic [Internet]. Mayo Foundation for Medical Education and Research; c2022. Liver disease; [cited 2022 Feb 24]; [about 8 screens]. Available from: https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502
  5. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [updated 2022 Mar 24; cited 2022 Feb 24]; [about 5 screens]. Available from: https://www.nhlbi.nih.gov/health/blood-tests
  6. Testing.com [Internet]. Seattle (WA).: OneCare Media; c2022–. Alanine Aminotransferase (ALT); [modified 2021 Nov 9; cited 2022 Feb 24]; [about 14 screens]. Available from: https://www.testing.com/tests/alanine-aminotransferase-alt/
  7. Testing.com [Internet]. Seattle (WA).: OneCare Media; c2022. Liver Panel; [modified 2021 Nov 9; cited 2022 Feb 24]; [about 13 screens]. Available from: https://www.testing.com/tests/liver-panel/
  8. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2022. Health Encyclopedia: ALT; [cited 2022 Feb 24]; [about 4 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=alt_sgpt

[Learn More in MedlinePlus]

AST Test

What is an AST Test?

AST (aspartate aminotransferase) is an enzyme that is found mostly in the liver, but it's also in muscles and other organs in your body. When cells that contain AST are damaged, they release the AST into your blood. An AST blood test measures the amount of AST in your blood. The test is commonly used to help diagnose liver damage or disease.

Other names: SGOT test, serum glutamic oxaloacetic transaminase test; aspartate transaminase test

What is it used for?

An AST blood test is often part of a routine blood screening to check the health of your liver. The test may help diagnose or monitor liver problems. It may also help diagnose other health conditions.

Why do I need an AST blood test?

You may get an AST blood test as part of your routine checkup or if you have symptoms of liver damage. These may include:

  • Nausea and vomiting
  • Lack of appetite
  • Fatigue
  • Weakness
  • Jaundice, a condition that causes your skin and eyes to turn yellow
  • Swelling and/or pain in your abdomen (belly)
  • Swelling in your ankles and legs
  • Dark-colored urine (pee) and/or light-colored stool (poop)
  • Frequent itching

Even if you don't have symptoms, your health care provider may order an AST blood test if you're more likely to develop liver disease because of:

  • A family history of liver disease
  • Alcohol use disorder
  • Obesity
  • Diabetes
  • Taking certain medicines that can cause liver damage
  • Hepatitis or exposure to hepatitis

What happens during an AST blood test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for an AST blood test. But an AST test is usually ordered with other blood tests. You usually need to fast (not eat or drink) for up to 12 hours before these tests. Your provider will let you know if there are any special instructions to follow.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

High levels of AST in the blood may be a sign of hepatitis, cirrhosis, mononucleosis, or other liver diseases. High AST levels may also be a sign of heart problems or pancreatitis.

If your results are not in the normal range, it doesn't always mean that you have a medical condition that needs treatment. Many things can affect your results, such as certain medicines and your age, sex, and diet. To learn what your results mean, talk with your provider.

Learn more about laboratory tests, reference ranges, and understanding results.

Is there anything else I need to know about an AST blood test?

Your health care provider may order an ALT blood test with your AST blood test. ALT stands for alanine transaminase, which is another type of liver enzyme. If you have high levels of AST and/or ALT, it may mean that you have some type of liver damage.

You may also have an AST test as part of a group of liver function tests that measure ALT, and other enzymes, proteins, and substances in the liver.

References

  1. American Liver Foundation. [Internet]. New York: American Liver Foundation; c2017. Diagnosing Liver Disease – Liver Biopsy and Liver Function Tests; [updated 2020 Feb 17; cited 2022 Feb 14]; [about 3 screens]. Available from: https://liverfoundation.org/for-patients/about-the-liver/diagnosing-liver-disease/
  2. Hinkle J, Cheever K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Aspartate Aminotransferase; p. 68–69.
  3. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2022 Feb 14]; [about 15 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  4. Testing.com [Internet]. Seattle (WA).: OneCare Media; c2022. Aspartate Aminotransferase: The Test; [modified 2021 Nov 9; cited 2022 Feb 14; [about 14 screens]. Available from: https://www.testing.com/test/aspartate-aminotransferase-ast/
  5. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2017. Health Encyclopedia: Aspartate Transaminase; [cited 2017 Mar 13]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=aspartate_transaminase

[Learn More in MedlinePlus]

Lactate Dehydrogenase (LDH) Test

What is a lactate dehydrogenase (LDH) test?

This test measures the level of lactate dehydrogenase (LDH), also known as lactic acid dehydrogenase, in your blood or sometimes in other body fluids. LDH is a type of protein, known as an enzyme. LDH plays an important role in making your body's energy. It is found in almost all the body's tissues, including those in the blood, heart, kidneys, brain, and lungs.

When these tissues are damaged, they release LDH into the bloodstream or other body fluids. If your LDH blood or fluid levels are high, it may mean certain tissues in your body have been damaged by disease or injury.

Other names: LD test, lactic dehydrogenase, lactic acid dehydrogenase

What is it used for?

An LDH test is most often used to:

  • Find out if you have tissue damage
  • Monitor disorders that cause tissue damage. These include anemia, liver disease, lung disease, and some types of infections.
  • Monitor chemotherapy for certain types cancer. The test may show if treatment is working.

Why do I need an LDH test?

You may need this test if other tests and/or your symptoms indicate you have tissue damage or disease. Symptoms will vary depending on the type of tissue damage you have.

You may also need an LDH test if you are currently being treated for cancer.

What happens during an LDH test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

LDH is sometimes measured in other body fluids, including fluids in the spinal cord, lungs, or abdomen. If you are having one of these tests, your health care provider will give more information about the procedure.

Will I need to do anything to prepare for the test?

You don't need any special preparations for an LDH blood test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

Higher than normal LDH levels usually means you have some type of tissue damage or disease. Disorders that cause high LDH levels include:

  • Anemia
  • Kidney disease
  • Liver disease
  • Muscle injury
  • Heart attack
  • Pancreatitis
  • Infections, including meningitis, encephalitis, and infectious mononucleosis (mono)
  • Certain types of cancer, including lymphoma and leukemia. A higher than normal LDH level may also mean treatment for cancer is not working.

Although the test can show if you have tissue damage or disease, it does not show where the damage is located. If your results showed higher than normal LDH levels, your provider may need to order more tests to make a diagnosis. One of these tests may be an LDH isoenzyme test. An LDH isoenzyme test measures different forms of LDH. It can help your provider find out about the location, type, and severity of tissue damage.

If you have questions about your results, talk to your health care provider.

Learn more about laboratory tests, reference ranges, and understanding results.

References

  1. Henry BM, Aggarwal G, Wong J, Benoit S, Vikse J, Plebani M, Lippi G. Lactate dehydrogenase levels predict coronavirus disease 2019 (COVID-19) severity and mortality: A pooled analysis. Am J Emerg Med [Internet]. 2020 May 27 [cited 2020 Aug 2]; 38(9):1722-1726. Available from: https://www.ajemjournal.com/article/S0735-6757(20)30436-8/fulltext
  2. Kids Health from Nemours [Internet]. Jacksonville (FL): The Nemours Foundation; c1995–2019. Blood Test: Lactate Dehydrogenase; [cited 2019 Jul 1]; [about 2 screens]. Available from: https://kidshealth.org/en/parents/test-ldh.html
  3. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Cerebrospinal Fluid (CSF); [updated 2017 Nov 30; cited 2019 Jul 1]; [about 3 screens]. Available from: https://labtestsonline.org/glossary/cerebrospinal
  4. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Lactate Dehydrogenase (LD); [updated 2018 Dec 20; cited 2019 Jul 1]; [about 2 screens]. Available from: https://labtestsonline.org/tests/lactate-dehydrogenase-ld
  5. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Meningitis and Encephalitis; [updated 2018 Feb 2; cited 2019 Jul 1]; [about 3 screens]. Available from: https://labtestsonline.org/conditions/meningitis-and-encephalitis
  6. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Peritoneal Fluid Analysis; [updated 2019 May 13; cited 2019 Jul 1]; [about 3 screens]. Available from: https://labtestsonline.org/tests/peritoneal-fluid-analysis
  7. Lab Tests Online [Internet]. Washington D.C.; American Association for Clinical Chemistry; c2001–2019. Pleural Fluid Analysis; [updated 2019 May 13; cited 2019 Jul 1]; [about 3 screens]. Available from: https://labtestsonline.org/tests/pleural-fluid-analysis
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests; [cited 2019 Jul 1]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  9. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2019. Health Encyclopedia: Lactic Acid Dehydrogenase (Blood); [cited 2019 Jul 1]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=167&contentid=lactic_acid_dehydrogenase_blood
  10. UF Health: University of Florida Health [Internet]. Gainesville (FL): University of Florida Health; c2019. Lactate dehydrogenase test: Overview; [updated 2019 Jul 1; cited 2019 Jul 1]; [about 2 screens]. Available from: https://ufhealth.org/lactate-dehydrogenase-test
  11. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2019. Lactic Acid Dehydrogenase (LDH): Exam Overview; [updated 2018 Jun 25; cited 2019 Jul 1]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/testdetail/lactic-dehydrogenase-ldh/tv6985.html#tv6986

[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - Code Deleted, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.

Footnotes

[1] Not chronic - A diagnosis code that does not fit the criteria for chronic condition (duration, ongoing medical treatment, and limitations) is considered not chronic. Some codes designated as not chronic are acute conditions. Other diagnosis codes that indicate a possible chronic condition, but for which the duration of the illness is not specified in the code description (i.e., we do not know the condition has lasted 12 months or longer) also are considered not chronic.