ICD-10 Code for Rhabdomyolysis

Potentially a life-threatening condition, rhabdomyolysis is characterized by the breakdown of skeletal muscle tissue, leading to the release of myoglobin and other intracellular contents into the bloodstream. If untreated, it can result in severe complications such as acute kidney injury (AKI). For nurses, early recognition and intervention help improve patient outcomes. 

In the ICD-10 system, rhabdomyolysis is classified under ICD-10 Code M62.82. This guide delves into the causes, symptoms, treatment approaches, and nursing considerations associated with this condition. 

What is the ICD-10 code for rhabdomyolysis? 

ICD-10 Code M62.82 specifically identifies rhabdomyolysis, the clinical condition involving muscle necrosis and the systemic release of muscle cell contents. 

• Definition: This is rhabdomyolysis resulting from trauma, exertion, medications, toxins, or other underlying causes.
• Inclusions: This can occur in cases where elevated levels of creatine kinase (CK) and/or myoglobin are confirmed, alongside clinical symptoms.
• Exclusions: Conditions like myositis or muscular dystrophies, which require separate codes, aren’t included. 

Nursing application for M62.82 

Nurses use ICD-10 Code M62.82 to document and classify rhabdomyolysis accurately, ensuring the patient receives appropriate diagnostic tests, monitoring, and interventions to prevent complications such as AKI. 

Causes and risk factors 

Rhabdomyolysis can occur due to various triggers, categorized as traumatic, non-traumatic, or exertional: 

1. Traumatic causes 

• Crush injuries: Often from motor vehicle accidents or building collapses
• Prolonged immobilization: Pressure on muscles from lying in one position for extended periods 

2. Non-traumatic causes 

• Medications: Statins, fibrates, or recreational drugs like cocaine
• Toxins: Snake venom or alcohol abuse
• Infections: Sepsis or severe viral infections like influenza or COVID-19 

3. Exertional causes 

• Intense physical activity: Marathon running, heavy weightlifting, or military training
• Heat stroke: Often seen in athletes or workers in extreme conditions 

Symptoms and diagnosis 

Understanding the symptoms and diagnostic indicators of rhabdomyolysis is necessary for timely treatment. 

Common symptoms 

• Muscle pain (myalgia), tenderness, and swelling
• Weakness or difficulty moving affected muscles
• Dark, cola-colored urine due to myoglobinuria
• Generalized fatigue, nausea, and confusion in severe cases 

Diagnostic indicators 

• Serum creatine kinase (CK): Levels greater than 1,000 U/L strongly suggest rhabdomyolysis
• Electrolyte imbalances: Hyperkalemia, hyperphosphatemia, or hypocalcemia
• Kidney function tests: Monitoring for signs of AKI 

Treatment approaches 

Effective management of rhabdomyolysis necessitates a comprehensive and timely approach to prevent complications. 

Immediate Interventions 

The primary goals of treatment are to prevent AKI and stabilize the patient, which include these actions: 

1. Aggressive fluid resuscitation: Use IV fluids to maintain urine output and flush out toxins.
2. Electrolyte correction: Address imbalances, particularly hyperkalemia, to prevent cardiac arrhythmias.
3. Urinary alkalization: Sodium bicarbonate may be administered to prevent myoglobin from crystallizing in the kidneys. 

Advanced management 

• Dialysis: This is used in severe cases where AKI progresses.
• Monitoring for complications: This includes disseminated intravascular coagulation (DIC) and compartment syndrome. 

Nursing responsibilities in treatment 

Nursing responsibilities in treatment include can promptly identify and address potential complications for this condition. 

1. Fluid management 

   1. Monitor IV fluid administration rates and urine output. A target output of 200-300 mL/hour is often recommended.
   2. Document urine color changes and report abnormalities promptly. 

2. Electrolyte monitoring 

   1. Watch for signs of hyperkalemia (e.g., ECG changes or muscle weakness) and hypocalcemia (e.g., numbness or tetany).
   2. Administer medications like calcium gluconate or insulin with glucose as prescribed. 

3. Skin and limb assessment 

   1. Regularly check for swelling or tightness in muscles, which could indicate compartment syndrome.
   2. Report and assist in managing symptoms of DIC if present. 

Complications of rhabdomyolysis 

If not managed promptly, rhabdomyolysis can lead to severe complications, such as: 

• Acute kidney injury (ICD-10 Code N17.9): Caused by myoglobin-induced renal damage
• Electrolyte imbalances (ICD-10 Code E87.6): Potentially life-threatening if not corrected
• Compartment syndrome (ICD-10 Code T79.6): A surgical emergency requiring fasciotomy 

Monitor for early signs of complications and escalate care as needed. 

Documentation tips for nurses 

Accurate documentation of rhabdomyolysis using ICD-10 Code M62.82 ensures proper care coordination and billing. Include the following: 

• Symptoms and clinical findings: Describe muscle pain, urine color changes, and lab results.
• Interventions: Detail IV fluid administration, medications, and electrolyte monitoring.
• Complications: Document any development of AKI, compartment syndrome, or other issues. 

Prevention strategies 

While some cases of rhabdomyolysis are unavoidable, nurses can help educate patients on prevention strategies, including these: 

• Hydration: Encourage adequate fluid intake, especially during physical activity or hot weather.
• Medication education: Alert patients to the risks of statin use and drug interactions.
• Gradual exercise progression: Recommend pacing physical activities to avoid overexertion. 

ICD-10 code sources: 

1. Centers for Disease Control and Prevention (CDC). (n.d.). Signs and symptoms of rhabdomyolysis. Retrieved from https://www.cdc.gov/niosh/rhabdo/signs-symptoms/index.html 
2. UpToDate. (2024). Rhabdomyolysis: Clinical manifestations and diagnosis. Retrieved from https://www.uptodate.com/contents/rhabdomyolysis-clinical-manifestations-and-diagnosis 
3. Shahabuddin A., De Brouwere V., Adhikari R., et al. (2011). Determinants of institutional delivery among young married women in Nepal: Evidence from the Nepal Demographic and Health Survey. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855463/