ICD-10 Code for Hypokalemia

Low potassium shows up constantly in routine labs, and most of the time it’s minor — a diuretic side effect, mild GI losses, nothing that needs more than an oral supplement and a recheck. E87.6 covers hypokalemia at any level, but what makes this particular diagnosis worth documenting carefully is the cardiac risk: potassium that’s low enough affects heart rhythm, and that connection is exactly what a payer wants to see explained when an EKG gets billed alongside a simple electrolyte finding.

If the note just says “low potassium, replace” without connecting it to anything else, that’s usually fine for a routine case. It stops being fine the moment you add an EKG, an inpatient admission, or IV replacement to the claim — at that point, the documentation needs to explain why this wasn’t a routine case.

FY 2027 ICD-10-CM (CMS, eff. 10/1/2026) · CPT 2026 (AMA) · Last verified: October 2026

Quick Answer

E87.6

Hypokalemia

E87.6 is billable and applies regardless of severity. If you’re also billing an EKG or IV potassium replacement, document the level and any cardiac symptoms — that’s what separates a routine finding from a claim that needs more support.

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ICD-10 Code for Hypokalemia: Full Code List and Related Diagnoses

ICD-10 Code Description Billable
E87.6 MOST USED Hypokalemia ✓
E87.5 Hyperkalemia ✓
E87.8 Other disorders of electrolyte and fluid balance, not elsewhere classified ✓
I49.9 Cardiac arrhythmia, unspecified ✓
R00.2 Palpitations ✓

CPT Codes Commonly Billed With This Diagnosis

CPT Code Description Medicare Rate* Common Modifiers
80053 Comprehensive metabolic panel ~$11 -59
80048 Basic metabolic panel ~$8 -59
93000 Electrocardiogram (EKG), with interpretation and report ~$15 -26, -TC
99214 Office visit, established patient, moderate complexity ~$136 -25
96374 IV push, single or initial substance ~$38 -25, -59

*Approximate 2026 CMS national non-facility rate. Lab test rates are from the 2026 CMS Clinical Laboratory Fee Schedule. Rates vary by geography, setting, and payer contract. Refer to the CMS Physician Fee Schedule for official rates.

Which Medical Specialty Handles This?

A mild, medication-related hypokalemia (common with diuretics) is managed and coded in primary care or internal medicine without much fuss. It becomes a cardiology concern the moment there's a documented rhythm change, palpitations, or an abnormal EKG connected to the low potassium — that combination is what justifies more intensive monitoring. Persistent or recurrent hypokalemia despite supplementation, especially without an obvious cause like diuretic use, often prompts a nephrology referral to look for a kidney-related explanation.

Common Billing & Documentation Mistakes

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EKG Billed Without Documented Cardiac Symptoms or Findings

93000 billed alongside a routine hypokalemia visit needs a documented reason — palpitations, known arrhythmia risk, or a level low enough to warrant cardiac monitoring — not just 'checked as routine.'

⚠

IV Replacement Billed Without Severity Documentation

96374 for IV potassium implies the case was severe enough that oral supplementation wasn’t appropriate. The note needs to state the potassium level and why IV route was chosen.

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Medication Cause Identified But Not Documented

Diuretic-induced hypokalemia is extremely common, but if the chart doesn’t connect the finding to the medication list, a reviewer has no way to confirm the clinical reasoning behind the treatment plan.

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Repeat Panels Ordered Without a Stated Recheck Reason

As with most electrolyte findings, repeat 80048/80053 orders close together need a documented reason — 'recheck after replacement' is enough, but it has to be there.

Coding Tips

  • Document the actual potassium value and whether there’s a known cause (diuretic use, GI losses, poor intake) — this one detail supports most of what gets billed alongside the diagnosis.
  • Only bill an EKG (93000) when there’s a documented reason to check for cardiac effects — a low level alone, without symptoms or risk factors, is a weaker justification.
  • For IV replacement, document the specific level that made oral supplementation inappropriate — this is what separates 96374 from a routine oral-replacement visit.
  • If hypokalemia recurs despite adequate replacement, document that pattern explicitly — it supports escalation to nephrology and rules out under-treatment on review.

Frequently Asked Questions

What is the ICD-10 code for hypokalemia?

E87.6. It applies regardless of how low the potassium level is — severity and cause need to be documented in the note, since the code itself doesn’t distinguish between mild and severe cases.

Does hypokalemia require an EKG?

Not automatically. An EKG (93000) is appropriate when there’s a clinical reason to check for cardiac effects — palpitations, a very low level, or known cardiac risk factors. Billing it as routine without that justification is a common denial trigger.

What’s the difference between E87.6 and E87.5?

E87.6 is low potassium (hypokalemia); E87.5 is high potassium (hyperkalemia). They’re opposite findings and are never billed together for the same lab result.

What CPT code is used for IV potassium replacement?

96374 covers the IV push administration. It should only be billed when the documented severity supports IV rather than oral replacement.

How does OmniMD support hypokalemia documentation?

OmniMD flags low potassium results against the patient’s active medication list, helping surface a likely cause automatically, and prompts for cardiac symptom documentation before an EKG order is placed.

Connect the Lab Result to the Right Clinical Story

OmniMD cross-references abnormal labs against medications and symptoms automatically, so your documentation keeps up.

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