hypokalemia

DEFINITION of hypokalemia

Hypokalemia is the most common electrolyte disorder encountered in clinical medicine, affecting an estimated 20% of hospitalized patients and representing a direct reflection of whole-body potassium depletion in most cases — though a critical minority of cases involve transcellular shift (potassium moving into cells without true body depletion, as in alkalosis, insulin excess, or catecholamine surge). The body’s serum potassium is maintained within the narrow range of 3.5-5.0 mEq/L through an exquisitely regulated balance of dietary intake, renal tubular reabsorption (primarily in the proximal tubule and loop of Henle), and aldosterone-driven distal collecting duct potassium secretion. The three major pathophysiological mechanisms are: decreased intake (rare in isolation, but clinically significant in anorexia, alcoholism, or prolonged NPO status); gastrointestinal losses (vomiting, diarrhea, ileostomy output, and nasogastric suctioning — among the most common causes in hospitalized patients); and renal potassium wasting (the dominant mechanism in patients on loop diuretics [furosemide, bumetanide, torsemide] or thiazide diuretics [hydrochlorothiazide, chlorthalidone], and in hyperaldosteronism, Cushing’s syndrome, Bartter syndrome, and Gitelman syndrome). The clinical consequences scale with severity: mild hypokalemia (K⁺ 3.0-3.5 mEq/L) produces fatigue, muscle cramps, and constipation; moderate (K⁺ 2.5-3.0 mEq/L) causes significant weakness and polyuria from nephrogenic diabetes insipidus; and severe hypokalemia (K⁺ < 2.5 mEq/L) can precipitate life-threatening ventricular arrhythmias — including torsades de pointes, ventricular tachycardia, and ventricular fibrillation — and respiratory muscle paralysis. Clinical Indicators: E87.6 is the single, fully billable ICD-10-CM code for ALL forms of hypokalemia — there are no subcategories for mild, moderate, severe, acute, or chronic hypokalemia. The code carries coding weight and supports medical necessity only when physician documentation reflects active management (not just an incidental lab value). Always document the underlying cause and code it separately — the most critical sequencing rules govern drug-induced hypokalemia (adverse effect T-codes, where the manifestation E87.6 is sequenced FIRST, followed by the T50.x5A adverse effect code for the causative drug).

ETYMOLOGY of hypokalemia

greek newlatin arabic medieval-latin

Component Origin Meaning
hypo- Ancient Greek ὑπό (hypó) “Under, below, beneath, less than normal” — the primary Greek prefix indicating a deficiency or sub-normal level; appears in hypokalemia, hyponatremia, hypoglycemia, hypovolemia, hypoxia; contrasted with hyper- (above normal)
kal- / kalium- New Latin kalium → Medieval Latin kali → Arabic al-qaliy ”Potassium” — the Neo-Latin name for potassium, derived from the Arabic al-qaliy (“plant ash/alkali”; from qala, “to roast in a pan”); Sir Humphry Davy isolated potassium in 1807 from potash (KOH) and named the element potassium in English; the systematic Latin name kalium — from kali — was proposed by the Swedish chemist Berzelius and is the basis of the chemical symbol K on the periodic table; appears in hypokalemia, hyperkalemia, kaluresis
-emia Ancient Greek αἷμα (haîma) “Blood” — the Greek root for blood; as a suffix (-emia) specifically denotes a condition of the blood or a substance within the blood; appears in anemia, bacteremia, hyperkalemia, acidemia, leukemia

Literally: “A below-normal level of potassium in the blood” — a precise compound coined in New Latin circa the late 19th-early 20th century following the formal discovery and naming of potassium (1807) and the development of serum electrolyte measurement. The term reflects the multilingual etymology of potassium itself: Greek prefix + Arabic-derived Neo-Latin element name + Greek blood suffix — making hypokalemia a rare Greek-Arabic-Greek compound hybrid in medical terminology, closely paralleling the hybrid construction of alkalosis (which also routes through the same Arabic al-qaliy root for its alkali- component). The British variant spelling hypokalaemia preserves the full Neo-Latin kalaemia form, though both spellings index to E87.6 identically in ICD-10-CM.

Component	Origin	Meaning
hypo-	Ancient Greek ὑπό (hypó)	“Under, below, beneath, less than normal” — the primary Greek prefix indicating a deficiency or sub-normal level; appears in hypokalemia, hyponatremia, hypoglycemia, hypovolemia, hypoxia; contrasted with hyper- (above normal)
kal- / kalium-	New Latin kalium → Medieval Latin kali → Arabic al-qaliy	”Potassium” — the Neo-Latin name for potassium, derived from the Arabic al-qaliy (“plant ash/alkali”; from qala, “to roast in a pan”); Sir Humphry Davy isolated potassium in 1807 from potash (KOH) and named the element potassium in English; the systematic Latin name kalium — from kali — was proposed by the Swedish chemist Berzelius and is the basis of the chemical symbol K on the periodic table; appears in hypokalemia, hyperkalemia, kaluresis
-emia	Ancient Greek αἷμα (haîma)	“Blood” — the Greek root for blood; as a suffix (-emia) specifically denotes a condition of the blood or a substance within the blood; appears in anemia, bacteremia, hyperkalemia, acidemia, leukemia

🔀 ALIASES / ALTERNATE TERMS

Term Context
Potassium deficiency The official ICD-10-CM “includes” synonym listed under E87.6; when a physician documents “potassium deficiency,” it indexes directly to E87.6 — no additional query needed.
Low potassium Common lay/clinical shorthand acceptable in documentation; indexes to E87.6.
Hypokalaemia The British/international spelling variant; functionally identical for ICD-10-CM coding purposes — both map to E87.6.
K⁺ deficiency / Low K+ Clinical lab and nursing shorthand; acceptable in physician attestation when paired with a documented serum potassium value and management plan.
Diuretic-induced hypokalemia The most common clinical subtype; coding requires E87.6 first (the manifestation), followed by the appropriate T50.x5x adverse effect code for the specific diuretic (e.g., T50.1X5A for furosemide) per ICD-10-CM adverse effect sequencing guidelines.
Refractory hypokalemia A clinically significant subtype in which potassium levels fail to normalize despite aggressive supplementation — most commonly due to concurrent hypomagnesemia; always check and code E83.42 (hypomagnesemia) when refractory hypokalemia is documented.

Term	Context
Potassium deficiency	The official ICD-10-CM “includes” synonym listed under E87.6; when a physician documents “potassium deficiency,” it indexes directly to E87.6 — no additional query needed.
Low potassium	Common lay/clinical shorthand acceptable in documentation; indexes to E87.6.
Hypokalaemia	The British/international spelling variant; functionally identical for ICD-10-CM coding purposes — both map to E87.6.
K⁺ deficiency / Low K+	Clinical lab and nursing shorthand; acceptable in physician attestation when paired with a documented serum potassium value and management plan.
Diuretic-induced hypokalemia	The most common clinical subtype; coding requires E87.6 first (the manifestation), followed by the appropriate T50.x5x adverse effect code for the specific diuretic (e.g., T50.1X5A for furosemide) per ICD-10-CM adverse effect sequencing guidelines.
Refractory hypokalemia	A clinically significant subtype in which potassium levels fail to normalize despite aggressive supplementation — most commonly due to concurrent hypomagnesemia; always check and code E83.42 (hypomagnesemia) when refractory hypokalemia is documented.

🔗 RELATED TERMS

alkalosis — E87.3; profoundly interrelated with hypokalemia — metabolic alkalosis drives potassium intracellularly (worsening hypokalemia) and conversely hypokalemia drives renal H⁺ loss (perpetuating alkalosis); the two conditions are so intertwined that coding one without the other when both are documented represents a CDI gap.

Hypomagnesemia — E83.42; the single most important co-diagnosis in refractory hypokalemia — magnesium depletion impairs renal potassium reabsorption, making potassium replacement ineffective until magnesium is normalized; always query the physician to document and code when present.

Hyperaldosteronism — E26.01 (Conn’s syndrome, primary adenoma) / E26.09 (other primary) / E26.1 (secondary); excess aldosterone drives renal potassium wasting as its primary mechanism of hypokalemia; must be coded as the primary etiology when documented.

Bartter syndrome — E26.81; a hereditary renal tubular channelopathy causing severe potassium-wasting in the loop of Henle; produces profound hypokalemia, metabolic alkalosis, hyperreninemia, and normotension without hypertension; requires explicit physician documentation.

Cushing’s syndrome — E24.0 (pituitary-dependent) / E24.2 (drug-induced) / E24.9 (unspecified); excess cortisol causes mineralocorticoid-like renal potassium wasting; document and code the Cushing’s type as the primary etiology.

Ventricular arrhythmia — I49.01 (ventricular fibrillation) / I49.02 (ventricular flutter) / I47.2 (ventricular tachycardia); the most life-threatening complication of severe hypokalemia (K⁺ < 2.5 mEq/L) — always code separately when documented and actively managed.

Torsades de pointes — I47.2 (ventricular tachycardia); the specific polymorphic VT triggered by hypokalemia-induced QT prolongation — particularly dangerous in patients on QT-prolonging drugs; code as an additional complication when documented.

hyponatremia — E87.1; frequently co-occurs with hypokalemia in patients on diuretics, vomiting patients, and those with SIADH; code both separately when documented.

Rhabdomyolysis — M62.82; severe hypokalemia can impair skeletal muscle membrane stability, precipitating myocyte destruction and rhabdomyolysis — an important complication to query the physician about when CK is dramatically elevated alongside severe hypokalemia.

CODING CORNER

🏥 ICD-10-CM CODES

Primary Diagnosis — Hypokalemia (E87.6)

⚠️ ICD-10-CM / Chapter Nuances: E87.6 is the single, fully billable code for ALL forms of hypokalemia — there are NO subcategories for mild/moderate/severe, acute/chronic, or etiology-specific subtypes. A critical sequencing rule governs drug-induced hypokalemia: per ICD-10-CM adverse effect guidelines (Section I.C.19.e), when hypokalemia is caused by a correctly prescribed and properly administered drug (e.g., furosemide, hydrochlorothiazide), E87.6 is sequenced FIRST (nature of the adverse effect), followed by the T50.x5A/D/S adverse effect code for the causative agent. This is opposite to poisoning sequencing (where the T-code leads). The Excludes1 note under E87 excludes electrolyte imbalance in hyperemesis gravidarum (O21.1) and following ectopic/molar pregnancy (O08.5) — do NOT report E87.6 in those obstetric contexts. Familial periodic paralysis (G72.3) is also Excludes1 from E87.6.

Code Description
E87.6 Hypokalemia (The single definitive billable code for all forms of low serum potassium; no subcategories exist; severity is reflected in documentation, lab values, and treatment — not in a separate code)

Drug-Induced Hypokalemia — Adverse Effect Sequencing

⚠️ Critical Sequencing Rule: For drug-induced hypokalemia from correctly prescribed medications, E87.6 goes FIRST, then the T-code adverse effect. This is one of the most commonly reversed sequencing errors in inpatient and outpatient coding.

Code Description
T50.1X5A Adverse effect of loop [high-ceiling] diuretics, initial encounter (Append AFTER E87.6 when furosemide, bumetanide, torsemide, or ethacrynic acid is the documented cause of hypokalemia — these are the most common drug causes)
T50.2X5A Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, initial encounter (Append AFTER E87.6 when a thiazide diuretic [HCTZ, chlorthalidone, metolazone] is the documented cause — also a very common pairing)
T46.1X5A Adverse effect of calcium-channel blockers, initial encounter (Less common — some CCBs can contribute to transcellular K⁺ shifts; verify physician documentation of causative relationship before appending)

Underlying Etiology / Complicating Condition Codes (Code Additionally)

Code Description
E83.42 Hypomagnesemia (The most critical co-diagnosis in refractory hypokalemia; magnesium deficiency prevents renal potassium conservation; code additionally — and query the physician — whenever potassium fails to correct despite aggressive replacement)
E87.3 Alkalosis (Code additionally when metabolic or respiratory alkalosis co-exists with hypokalemia; the two conditions perpetuate each other and both must be independently documented and coded)
E26.01 Primary hyperaldosteronism due to adenoma (Code as the primary etiology when Conn’s syndrome [aldosterone-producing adenoma] is documented as the cause of potassium wasting)
E26.09 Other primary hyperaldosteronism (Bilateral adrenal hyperplasia or non-adenoma primary hyperaldosteronism causing renal K⁺ wasting)
E26.1 Secondary hyperaldosteronism (Renal artery stenosis, heart failure, cirrhosis with ascites driving aldosterone excess and hypokalemia)
E26.81 Bartter’s syndrome (Hereditary renal K⁺-wasting channelopathy; requires explicit physician documentation — profound hypokalemia, metabolic alkalosis, normotension)
E24.0 Cushing’s disease (Pituitary-dependent hypercortisolism causing mineralocorticoid-like renal K⁺ wasting; code as primary etiology when documented)
E24.9 Cushing’s syndrome, unspecified (When the type of Cushing’s is not further specified)
R11.2 Nausea with vomiting, unspecified (Code when protracted vomiting is the documented cause of hypokalemia via GI potassium loss)
K91.1 Postgastric surgery syndromes (Including diarrhea or GI dysfunction following bariatric or GI surgery causing potassium depletion)

Complications of Hypokalemia (Code Additionally When Documented)

Code Description
I49.01 Ventricular fibrillation (Code additionally as a complication of severe hypokalemia when VF is documented and managed — hypokalemia-induced VF dramatically elevates DRG severity and complexity)
I47.2 Ventricular tachycardia (Code additionally when VT or torsades de pointes is documented in the setting of hypokalemia)
I48.0 Paroxysmal atrial fibrillation (Hypokalemia lowers the threshold for atrial arrhythmias — code AF separately when documented)
M62.82 Rhabdomyolysis (Severe hypokalemia-induced muscle breakdown; code additionally when both are documented and active management of rhabdomyolysis is occurring)

🔧 COMMON CPT CODES (Evaluation, Monitoring & Treatment)

Laboratory Testing

⚠️ CPT Nuance: 84132 is the individual serum potassium code — do NOT separately report it if a 80047 or 80048 (basic metabolic panel) was already billed from the same blood draw; potassium is a component of the BMP/CMP and unbundling it constitutes duplicate billing. For repeat same-day potassium checks (e.g., Q4H monitoring during IV replacement), append modifier -91 to 84132 for each repeat draw.

CPT Code Description
84132 Potassium; serum, plasma or whole blood (The definitive diagnostic code for serum K⁺ measurement; do NOT separately bill alongside 80047 or 80048 BMP/CMP for the same specimen)
80047 Basic metabolic panel (Calcium, ionized) (Includes potassium, sodium, chloride, CO₂, glucose, BUN, creatinine — do NOT separately bill 84132 when BMP is already billed)
80048 Basic metabolic panel (Calcium, total) (The most commonly ordered BMP; includes potassium — same unbundling rule applies)
84295 Sodium; serum, plasma or whole blood (Report separately for serum sodium when evaluating co-existing hyponatremia or when calculating electrolyte ratios outside a panel context)
83735 Magnesium (Report separately — always ordered alongside K⁺ in hypokalemia management since hypomagnesemia drives refractory hypokalemia; NOT included in the standard BMP — must be separately ordered and billed)
82374 Carbon dioxide (bicarbonate) (Serum bicarbonate to identify co-existing metabolic alkalosis; NOT included in all panel configurations — verify inclusion before billing separately)

Cardiac Monitoring

⚠️ CPT Nuance: 93000 includes the tracing, interpretation, AND report — all three components in one code. Do NOT report 93010 (interpretation only) alongside 93000 for the same EKG. Continuous telemetry monitoring (93041/93042/93043) is separately reportable from the routine 12-lead EKG.

CPT Code Description
93000 Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report (The complete 12-lead ECG code — includes tracing, interpretation, and report; essential for evaluating hypokalemia-induced U waves, ST depression, QT prolongation, and arrhythmia risk; report once per ECG performed)
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only (Report ONLY when the physician provides interpretation and report for an EKG tracing generated by hospital/technical staff — do NOT use alongside 93000 for the same tracing)
93041 Rhythm ECG, 1-3 leads; tracing only without interpretation and report (Rhythm strip — report for telemetry-based rhythm strip monitoring in a patient with hypokalemia-associated cardiac monitoring; when interpretation is added, use 93042 instead)
93042 Rhythm ECG, 1-3 leads; with interpretation and report (Report when physician interprets and documents a rhythm strip for hypokalemia-related arrhythmia monitoring)

Treatment — Potassium Replacement

⚠️ CPT Nuance: For IV potassium replacement, 96365 + 96366 (infusion codes) apply when IV potassium chloride or IV potassium phosphate is infused therapeutically. When oral potassium supplementation is the only treatment, no procedure CPT is typically billable beyond the E&M visit. 96374 (IV push) is used for smaller bolus doses; verify payer-specific policies on concurrent infusion + push billing.

CPT Code Description
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour (Report for IV potassium chloride (KCl) infusion — the primary treatment for moderate-to-severe hypokalemia when oral route is insufficient or contraindicated; requires physician order with documented dose, rate, and indication)
96366 +Intravenous infusion, each additional hour (Add-on; report for each additional hour of IV KCl infusion beyond the first; list separately in addition to 96365; never alone)
96374 Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance/drug (Report for IV push administration of potassium when a smaller bolus dose is administered as an IV push rather than a continuous infusion)
96375 +Each additional sequential intravenous push of a new substance/drug (Add-on; report when a second or subsequent drug is administered by IV push at the same session alongside potassium — e.g., IV magnesium sulfate for concurrent hypomagnesemia; never alone)

Modifiers Commonly Used

Modifier Usage
-91 Repeat clinical diagnostic laboratory test — Append to 84132 for each repeat same-day serum potassium drawn to monitor response to replacement therapy (e.g., Q4H potassium checks during IV KCl infusion); do NOT use for equipment malfunction reruns
-25 Significant, separately identifiable E/M service — Append to 99213 / 99214 / 99223 when the physician performs a separately documented E/M on the same day as IV infusion initiation (96365) or an ECG (93000)
-59 Distinct procedural service — Append to 83735 (magnesium) when billed on the same date as other electrolyte labs to distinguish it as a separately indicated, clinically distinct order (magnesium is NOT bundled in BMP — this modifier is not typically needed for Mg but may be required by specific payers)
-QW CLIA-waived test — Append to 84132 when point-of-care potassium testing is performed on a CLIA-waived handheld analyzer at the bedside rather than in a certified lab; required by most payers for waived test reimbursement

⚠️ Coding Note: The two highest-impact compliance rules in hypokalemia coding are adverse effect sequencing and incidental vs. clinically significant coding. On sequencing: when diuretic-induced hypokalemia is the scenario, E87.6 must always be sequenced BEFORE the T50.x5A adverse effect code — the manifestation leads in adverse effect coding, not the drug. Reversing this sequence (T-code first, then E87.6) is the most common error and directly violates ICD-10-CM Section I.C.19.e guidelines. On significance: per ICD-10-CM coding guidelines, an electrolyte abnormality should only be coded as a reportable diagnosis when it affects patient management — a potassium of 3.4 that was noted but not treated does not support E87.6 as a codeable condition; the physician must document that hypokalemia influenced clinical decision-making (e.g., oral or IV replacement was ordered, cardiac monitoring was initiated, a medication was held). For refractory hypokalemia, the failure to co-code E83.42 (hypomagnesemia) when both are present is a CDI gap that affects severity and risk adjustment — query the physician whenever potassium fails to correct with standard replacement. For cardiac monitoring, never report 93000 and 93010 for the same ECG — 93000 is the global code that includes interpretation; 93010 is only the interpretation component and creates an NCCI conflict when billed alongside the global 93000.

Code	Description
E87.6	Hypokalemia (The single definitive billable code for all forms of low serum potassium; no subcategories exist; severity is reflected in documentation, lab values, and treatment — not in a separate code)

Code	Description
T50.1X5A	Adverse effect of loop [high-ceiling] diuretics, initial encounter (Append AFTER E87.6* when furosemide, bumetanide, torsemide, or ethacrynic acid is the documented cause of hypokalemia — these are the most common drug causes)*
T50.2X5A	Adverse effect of carbonic-anhydrase inhibitors, benzothiadiazides and other diuretics, initial encounter (Append AFTER E87.6* when a thiazide diuretic [HCTZ, chlorthalidone, metolazone] is the documented cause — also a very common pairing)*
T46.1X5A	Adverse effect of calcium-channel blockers, initial encounter (Less common — some CCBs can contribute to transcellular K⁺ shifts; verify physician documentation of causative relationship before appending)

Code	Description
E83.42	Hypomagnesemia (The most critical co-diagnosis in refractory hypokalemia; magnesium deficiency prevents renal potassium conservation; code additionally — and query the physician — whenever potassium fails to correct despite aggressive replacement)
E87.3	Alkalosis (Code additionally when metabolic or respiratory alkalosis co-exists with hypokalemia; the two conditions perpetuate each other and both must be independently documented and coded)
E26.01	Primary hyperaldosteronism due to adenoma (Code as the primary etiology when Conn’s syndrome [aldosterone-producing adenoma] is documented as the cause of potassium wasting)
E26.09	Other primary hyperaldosteronism (Bilateral adrenal hyperplasia or non-adenoma primary hyperaldosteronism causing renal K⁺ wasting)
E26.1	Secondary hyperaldosteronism (Renal artery stenosis, heart failure, cirrhosis with ascites driving aldosterone excess and hypokalemia)
E26.81	Bartter’s syndrome (Hereditary renal K⁺-wasting channelopathy; requires explicit physician documentation — profound hypokalemia, metabolic alkalosis, normotension)
E24.0	Cushing’s disease (Pituitary-dependent hypercortisolism causing mineralocorticoid-like renal K⁺ wasting; code as primary etiology when documented)
E24.9	Cushing’s syndrome, unspecified (When the type of Cushing’s is not further specified)
R11.2	Nausea with vomiting, unspecified (Code when protracted vomiting is the documented cause of hypokalemia via GI potassium loss)
K91.1	Postgastric surgery syndromes (Including diarrhea or GI dysfunction following bariatric or GI surgery causing potassium depletion)

Code	Description
I49.01	Ventricular fibrillation (Code additionally as a complication of severe hypokalemia when VF is documented and managed — hypokalemia-induced VF dramatically elevates DRG severity and complexity)
I47.2	Ventricular tachycardia (Code additionally when VT or torsades de pointes is documented in the setting of hypokalemia)
I48.0	Paroxysmal atrial fibrillation (Hypokalemia lowers the threshold for atrial arrhythmias — code AF separately when documented)
M62.82	Rhabdomyolysis (Severe hypokalemia-induced muscle breakdown; code additionally when both are documented and active management of rhabdomyolysis is occurring)

CPT Code	Description
84132	Potassium; serum, plasma or whole blood (The definitive diagnostic code for serum K⁺ measurement; do NOT separately bill alongside 80047* or 80048 BMP/CMP for the same specimen)*
80047	Basic metabolic panel (Calcium, ionized) (Includes potassium, sodium, chloride, CO₂, glucose, BUN, creatinine — do NOT separately bill 84132 when BMP is already billed)
80048	Basic metabolic panel (Calcium, total) (The most commonly ordered BMP; includes potassium — same unbundling rule applies)
84295	Sodium; serum, plasma or whole blood (Report separately for serum sodium when evaluating co-existing hyponatremia or when calculating electrolyte ratios outside a panel context)
83735	Magnesium (Report separately — always ordered alongside K⁺ in hypokalemia management since hypomagnesemia drives refractory hypokalemia; NOT included in the standard BMP — must be separately ordered and billed)
82374	Carbon dioxide (bicarbonate) (Serum bicarbonate to identify co-existing metabolic alkalosis; NOT included in all panel configurations — verify inclusion before billing separately)

CPT Code	Description
93000	Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report (The complete 12-lead ECG code — includes tracing, interpretation, and report; essential for evaluating hypokalemia-induced U waves, ST depression, QT prolongation, and arrhythmia risk; report once per ECG performed)
93010	Electrocardiogram, routine ECG with at least 12 leads; interpretation and report only (Report ONLY when the physician provides interpretation and report for an EKG tracing generated by hospital/technical staff — do NOT use alongside 93000 for the same tracing)
93041	Rhythm ECG, 1-3 leads; tracing only without interpretation and report (Rhythm strip — report for telemetry-based rhythm strip monitoring in a patient with hypokalemia-associated cardiac monitoring; when interpretation is added, use 93042* instead)*
93042	Rhythm ECG, 1-3 leads; with interpretation and report (Report when physician interprets and documents a rhythm strip for hypokalemia-related arrhythmia monitoring)

CPT Code	Description
96365	Intravenous infusion, for therapy, prophylaxis, or diagnosis; initial, up to 1 hour (Report for IV potassium chloride (KCl) infusion — the primary treatment for moderate-to-severe hypokalemia when oral route is insufficient or contraindicated; requires physician order with documented dose, rate, and indication)
96366	+Intravenous infusion, each additional hour (Add-on; report for each additional hour of IV KCl infusion beyond the first; list separately in addition to 96365; never alone)
96374	Therapeutic, prophylactic, or diagnostic injection; intravenous push, single or initial substance/drug (Report for IV push administration of potassium when a smaller bolus dose is administered as an IV push rather than a continuous infusion)
96375	+Each additional sequential intravenous push of a new substance/drug (Add-on; report when a second or subsequent drug is administered by IV push at the same session alongside potassium — e.g., IV magnesium sulfate for concurrent hypomagnesemia; never alone)

Modifier	Usage
-91	Repeat clinical diagnostic laboratory test — Append to 84132 for each repeat same-day serum potassium drawn to monitor response to replacement therapy (e.g., Q4H potassium checks during IV KCl infusion); do NOT use for equipment malfunction reruns
-25	Significant, separately identifiable E/M service — Append to 99213 / 99214 / 99223 when the physician performs a separately documented E/M on the same day as IV infusion initiation (96365) or an ECG (93000)
-59	Distinct procedural service — Append to 83735 (magnesium) when billed on the same date as other electrolyte labs to distinguish it as a separately indicated, clinically distinct order (magnesium is NOT bundled in BMP — this modifier is not typically needed for Mg but may be required by specific payers)
-QW	CLIA-waived test — Append to 84132 when point-of-care potassium testing is performed on a CLIA-waived handheld analyzer at the bedside rather than in a certified lab; required by most payers for waived test reimbursement

DERIVATIONS of hypokalemia

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Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms

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hypokalemia

🏥 ICD-10-CM CODES

Primary Diagnosis — Hypokalemia (E87.6)

Drug-Induced Hypokalemia — Adverse Effect Sequencing

Underlying Etiology / Complicating Condition Codes (Code Additionally)

Complications of Hypokalemia (Code Additionally When Documented)

🔧 COMMON CPT CODES (Evaluation, Monitoring & Treatment)

Laboratory Testing

Cardiac Monitoring

Treatment — Potassium Replacement

Modifiers Commonly Used

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Prefixes and Suffixes