R74.0 ICD-10-CM Code: Nonspecific elevation of levels of transaminase and lactic acid dehydrogenase [LDH]

Coding instructions

Official Tabular Instructional Notes: the inclusion, exclusion and sequencing notes published for R74.0 in the official ICD-10-CM tabular list, quoted as published.

Notes without a marker are published on R74.0 itself; “inherited from” names the category or block whose note applies here.

Coder workflow for R74.0

MedCoder structured workflow — derived from this code’s own official record

Before you code R74.0

1. R74.0 is not reportable as written. Select the more specific code beneath it that the documentation supports. Codes are reported to the highest level of specificity the classification provides (Guidelines I.B.2).

   ReviewR74.01, R74.02

   See the relationships section · Guide: How to choose an ICD-10-CM code →

2. Check whether an established diagnosis that explains this sign or symptom is documented. If one is, review whether the documented diagnosis changes the coding pathway: a symptom that is integral to a confirmed diagnosis is not reported separately, while one not routinely associated with it may be. Signs and symptoms are reported when no definitive diagnosis is established (Guidelines I.B.4, I.B.5, I.B.6, I.C.18.b).

   Guide: Symptom code vs confirmed diagnosis →

Choose the right path

1. Does the documentation support one of the more specific codes beneath R74.0?
   Yes → Select that code and continue the checks below on its own page.
   No → R74.0 cannot be reported as written; query for the specificity its subcategory needs.

   ReviewR74.01, R74.02

2. Is an established diagnosis that explains this sign or symptom documented?
   Yes → Review whether the documented diagnosis changes the coding pathway: a symptom integral to it is not reported separately.
   No → Continue — the sign or symptom code stands when no definitive diagnosis is established.

Consider R74.0. Then confirm the code is valid for the date of service in the Verify section.

Documentation check

The provider’s diagnostic statement

Codes are assigned from the provider’s documented diagnosis, not from clinical criteria, test values or a medication list (Guidelines I.A.19).

Official instructions as workflow

• Excludes2 — not part of R74.0(7 notes)

  Coding workflow: The conditions named in this note are not included in R74.0. When the record documents both, both may be reported; the note is a boundary, not a prohibition.

  CompareO28, E78, D69

  See the official tabular notes · Guidelines I.A.12.b

Coding decision scenarios

Pattern scenarios for this code’s structure — decision rules, not clinical cases

Every row is derived from this code’s own record — its title, tabular notes, 7th-character family and same-category siblings — with fixed MedCoder wording; nothing is inferred about a patient. The official notes and guideline text are in the sections each row links to, and they control.

Don’t confuse R74.0 with…

MedCoder analysis — pairs from this code’s official notes, distinctions written by MedCoder

The codes most likely to be picked instead of R74.0 — named in its own official notes, or sharing its laterality or encounter family — with what separates them and which documentation moves the case. Each links to the full comparison.

• R74.9— Specificity relationship (Review)

  Overlapping diagnoses in the same category.

  Overlapping codes in the same category — the documentation decides which is the more specific fit.

  What moves you there: A record that documents no more than “Abnormal serum enzyme level, unspecified” takes R74.9; specificity in the record moves it back here.

  Full comparison: R74.0 vs R74.9 →

• O28— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abnormal findings on antenatal screening of mother adds O28; it is not part of this code and both may be reported when both are documented.

  Full comparison: R74.0 vs O28 →

• E78— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abnormalities of lipids adds E78; it is not part of this code and both may be reported when both are documented.

  Full comparison: R74.0 vs E78 →

• D69— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abnormalities of platelets and thrombocytes adds D69; it is not part of this code and both may be reported when both are documented.

  Full comparison: R74.0 vs D69 →

• D70— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abnormalities of white blood cells classified elsewhere adds D70; it is not part of this code and both may be reported when both are documented.

  Full comparison: R74.0 vs D70 →

• D72— Excludes2 relationship (Informational)

  Distinct conditions — both may be reported.

  A distinct condition — both may be reported when both are documented.

  What moves you there: Documentation of abnormalities of white blood cells classified elsewhere adds D72; it is not part of this code and both may be reported when both are documented.

  Full comparison: R74.0 vs D72 →

Relationships are read from this code's own official notes, its laterality siblings and its encounter family; the wording of each distinction is MedCoder editorial, and the documentation named in each “what moves you there” line is the official note phrase or sibling title itself. Source: CMS ICD-10-CM tabular instructional notes; ICD-10-CM Official Guidelines, Section I.A.12.a.

Verify Before Coding

• Not billable as written — a more specific code is required: R74.01, R74.02.

From the code registry, the Medicare Code Editor, and the MS-DRG Definitions Manual. Check it against a full claim in Claim Check.

Relationships & Classification

MedCoder structured relationships — computed from published CMS and AHRQ datasets

Other codes that name R74.0 or its code family, from the CMS ICD-10-CM tabular instructional notes. Tabular-note edges are stored at the code family level that carries each note.

Referenced by 8 Excludes2 notes: R83 — Abnormal findings in cerebrospinal fluid (via R74.-), R83-R89 — Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89) (via R74.-), R84 — Abnormal findings in specimens from respiratory organs and thorax (via R74.-), R85 — Abnormal findings in specimens from digestive organs and abdominal cavity (via R74.-), R86 — Abnormal findings in specimens from male genital organs (via R74.-), R87 — Abnormal findings in specimens from female genital organs (via R74.-), R88 — Abnormal findings in other body fluids and substances (via R74.-), R89 — Abnormal findings in specimens from other organs, systems and tissues (via R74.-).

These codes’ tabular lists name this diagnosis as distinct — both may be reported when both are documented.

Clinical classification (AHRQ CCSR):SYM017 — Abnormal findings without diagnosis (default).

Clinical Classifications Software Refined (CCSR) for ICD-10-CM Diagnoses. Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality.

Related Codes

Same clinical category (CCSR)

AHRQ's Clinical Classifications Software groups these diagnoses under the same clinical category (Abnormal findings without diagnosis).

R70.0 — Elevated erythrocyte sedimentation rate, R70.1 — Abnormal plasma viscosity, R71.0 — Precipitous drop in hematocrit, R71.8 — Other abnormality of red blood cells, R73.01 — Impaired fasting glucose, R73.02 — Impaired glucose tolerance (oral), R73.09 — Other abnormal glucose, R73.9 — Hyperglycemia, unspecified, R74.01 — Elevation of levels of liver transaminase levels, R74.02 — Elevation of levels of lactic acid dehydrogenase [LDH], R74.8 — Abnormal levels of other serum enzymes, R74.9 — Abnormal serum enzyme level, unspecified, R75 — Inconclusive laboratory evidence of human immunodeficiency virus [HIV], R76.0 — Raised antibody titer, R76.11 — Nonspecific reaction to tuberculin skin test without active tuberculosis, R76.12 — Nonspecific reaction to cell mediated immunity measurement of gamma interferon antigen response without active tuberculosis, R76.8 — Other specified abnormal immunological findings in serum, R76.81 — Abnormal rheumatoid factor and anti-citrullinated protein antibody without rheumatoid arthritis, R76.89 — Other specified abnormal immunological findings in serum, R76.9 — Abnormal immunological finding in serum, unspecified, +183 more

Contextual Map

Every relationship of R74.0 in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

Run R74.0 with these 8 related codes in Claim Check

Hierarchy

• R00-R99 — Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00-R99) (R00-R99)[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R70-R79 — Abnormal findings on examination of blood, without diagnosis[Hierarchy]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Referenced by Excludes2 notes

• R83 — Abnormal findings in cerebrospinal fluid[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R83-R89 — Abnormal findings on examination of other body fluids, substances and tissues, without diagnosis (R83-R89)[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R84 — Abnormal findings in specimens from respiratory organs and thorax[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R85 — Abnormal findings in specimens from digestive organs and abdominal cavity[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R86 — Abnormal findings in specimens from male genital organs[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R87 — Abnormal findings in specimens from female genital organs[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R88 — Abnormal findings in other body fluids and substances[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026
• R89 — Abnormal findings in specimens from other organs, systems and tissues[Excludes2](via R74.-): “abnormal findings on examination of blood, without diagnosis (R70-R79)”— CMS ICD-10-CM tabular instructional notes · icd10cm-fy2026

Clinical classification (CCSR)

• SYM017 — Abnormal findings without diagnosis[CCSR]— AHRQ CCSR for ICD-10-CM Diagnoses (HCUP)

Nearest codes

• R74 — Abnormal serum enzyme levels[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R74.01 — Elevation of levels of liver transaminase levels[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R74.02 — Elevation of levels of lactic acid dehydrogenase [LDH][Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R74.8 — Abnormal levels of other serum enzymes[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026
• R74.9 — Abnormal serum enzyme level, unspecified[Sibling]— CMS ICD-10-CM tabular structure · icd10cm-fy2026

Change history (2)

• FY2021 — Became a non-billable header[Change history]— CMS release files (code change ledger) · icd10cm-fy2021
• and 1 more

Common coding questions

Sources for this page

Codes, titles, notes, index terms and mappings on this page are transcribed from the datasets below. Relationships MedCoder computed and text MedCoder wrote are labelled where they appear.

Code, title, tabular notes and index terms Official source data

CMS/CDC ICD-10-CM FY2026 tabular list, index and tables, effective October 1, 2025 Release, file and checksum · Publisher’s page

Claim edits Official source data

CMS Definitions of Medicare Code Edits — v43.1 (April 2026) Release, file and checksum · Publisher’s page

Change history and date-of-service validity Official source data

CMS ICD-10-CM release addenda, ingested release by release into the change ledger Release, file and checksum · Publisher’s page

Comparisons, relationships and the contextual map MedCoder structured relationship

Computed by MedCoder from the tabular notes and tables above; every derived relationship is marked as derived where it appears

Summary and FAQ answers MedCoder explanation

Written by MedCoder to explain the sources above: drafted with AI assistance, checked by a person against the release files, and labelled as MedCoder text where it appears. Not official text.

Labels on this page: Official source data · MedCoder structured relationship · MedCoder explanation. How to read the labels · All data sources and release dates

Nearest Codes in This Family

Official ICD-10-CM classifications closest to R74.0 in its code family, with their registry titles.

• R74 — Abnormal serum enzyme levels
• R74.01 — Elevation of levels of liver transaminase levels
• R74.02 — Elevation of levels of lactic acid dehydrogenase [LDH]
• R74.8 — Abnormal levels of other serum enzymes
• R74.9 — Abnormal serum enzyme level, unspecified

View all codes in the R74 family