ICD-10 Coding for Elevated Prolactin(E22.1, D35.2)
Complete ICD-10-CM coding and documentation guide for Elevated Prolactin. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Elevated Prolactin
E22.0-E23.7Primary Range
Disorders of pituitary gland
This range includes conditions related to pituitary gland dysfunction, including hyperprolactinemia.
Adverse effect of antipsychotics
Relevant for cases where elevated prolactin is due to medication effects.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E22.1 | Hyperprolactinemia | Use when elevated prolactin is confirmed without an identifiable cause. |
|
| D35.2 | Benign neoplasm of pituitary gland | Use when a prolactinoma is confirmed as the cause of elevated prolactin. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for elevated prolactin
Essential facts and insights about Elevated Prolactin
Primary ICD-10-CM Codes for elevated prolactin
Decision Criteria
clinical Criteria
- Prolactin levels >700 mIU/L with no identifiable cause
coding Criteria
- Exclusion of prolactinoma or medication-induced causes
Applicable To
- Idiopathic hyperprolactinemia
Excludes
- Prolactinoma (D35.2)
Clinical Validation Requirements
- Prolactin levels >700 mIU/L
- Exclusion of known causes
Code-Specific Risks
- Incorrect use without ruling out other causes
Coding Notes
- Ensure to document the cause if known, and sequence appropriately.
D35.2 - Benign neoplasm of pituitary gland
Use when a prolactinoma is confirmed as the cause of elevated prolactin.
Applicable To
- Prolactinoma
Excludes
- Hyperprolactinemia without adenoma (E22.1)
Clinical Validation Requirements
- MRI confirmation of pituitary adenoma
Coding Notes
Document MRI findings clearly to support coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Hypopituitarism
E23.0Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Elevated Prolactin to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E22.1.
Impact
Clinical: Inaccurate treatment planning., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Thoroughly evaluate and document all potential causes.
Impact
Reimbursement: May lead to claim denials if incorrect coding is used., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Ensure all potential causes are evaluated and documented.
Impact
Failure to sequence etiology before manifestation.
Mitigation Strategy
Educate staff on proper sequencing rules.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Elevated Prolactin, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Elevated Prolactin
Use these documentation templates to ensure complete and accurate documentation for Elevated Prolactin. These templates include all required elements for proper coding and billing.
Hyperprolactinemia due to prolactinoma
Specialty: EndocrinologyRequired Elements
- Prolactin levels
- MRI findings
- Symptoms
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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