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ICD-10 Coding for Excessive Sweating(L74.510, R61)

Complete ICD-10-CM coding and documentation guide for Excessive Sweating. Includes clinical validation requirements, documentation requirements, and coding pitfalls.

Also known as:

HyperhidrosisExcessive perspiration

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Related ICD-10 Code Ranges

Complete code families applicable to Excessive Sweating

L74.5Primary Range

Primary focal hyperhidrosis

This range covers idiopathic, bilateral sweating in specific areas such as the axilla, palms, and soles.

R61

Generalized hyperhidrosis

This code is used for whole-body sweating with systemic triggers.

Code Comparison: When to Use Each Code

Compare key differences between these codes to ensure accurate selection

CodeDescriptionWhen to UseKey Documentation
L74.510Primary focal hyperhidrosis, axillaUse when the patient has idiopathic, bilateral axillary sweating with significant impact on daily life.
  • HDSS score of 3-4
  • Iodine-starch test showing ≥5 cm darkening
R61Generalized hyperhidrosisUse for whole-body sweating with systemic triggers like menopause or hyperthyroidism.
  • Systemic condition causing sweating
  • Negative for focal hyperhidrosis tests

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 excessive sweating

Essential facts and insights about Excessive Sweating

The ICD-10 code for primary focal hyperhidrosis is L74.5, while generalized hyperhidrosis is coded as R61.

Primary ICD-10-CM Codes for excessive sweating

L74.510
Primary focal hyperhidrosis, axilla
Billable Code

Decision Criteria

clinical Criteria

  • Bilateral axillary sweating with HDSS score of 3-4

Applicable To

  • Bilateral axillary sweating

Excludes

  • Generalized hyperhidrosis (R61)

Clinical Validation Requirements

  • HDSS score of 3-4
  • Iodine-starch test showing ≥5 cm darkening

Code-Specific Risks

  • Incorrectly coding as generalized hyperhidrosis

Coding Notes

  • Ensure documentation specifies bilateral involvement and significant impact on daily activities.
View Full Code Details

Ancillary Codes

Additional codes that should be used in conjunction with the main diagnosis codes when applicable.

Hyperthyroidism, unspecified

E05.90
Use when hyperhidrosis is due to hyperthyroidism.

Differential Codes

Alternative codes to consider when ruling out similar conditions to the primary diagnosis.

Generalized hyperhidrosis

R61
Use R61 for whole-body sweating due to systemic conditions.

Primary focal hyperhidrosis, axilla

L74.510
Use L74.510 for localized axillary sweating.

Documentation & Coding Risks

Avoid these common documentation and coding issues when documenting Excessive Sweating to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code L74.510.

Impact

Clinical: Inadequate treatment planning, Regulatory: Potential audit issues, Financial: Claim denials due to lack of specificity

Mitigation Strategy

Use specific descriptors for symptoms, Include HDSS scores

Impact

Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.

Mitigation Strategy

Differentiate between generalized and focal hyperhidrosis based on clinical presentation.

Impact

Using generalized codes for focal conditions.

Mitigation Strategy

Ensure thorough clinical assessment and documentation.

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 Excessive Sweating, with expert answers to help guide accurate code selection and documentation.

Documentation Templates for Excessive Sweating

Use these documentation templates to ensure complete and accurate documentation for Excessive Sweating. These templates include all required elements for proper coding and billing.

Dermatology Progress Note

Specialty: Dermatology

Required Elements

  • Subjective symptoms
  • Objective findings
  • Assessment
  • Plan

Example Documentation

**Subjective:** "35yo F reports 8-year history of bilateral axillary sweating occurring ≥5x/day, unrelated to heat/exercise. HDSS 4 ('My sweating is intolerable and always interferes with daily activities'). Failed Drysol (30% aluminum chloride) ×6 months with persistent skin irritation." **Objective:** Iodine-starch test: 8x6 cm darkening bilateral axillae. **Assessment:** Primary focal hyperhidrosis, axilla (L74.510). **Plan:** Initiate botulinum toxin injections (64650).

Examples: Poor vs. Good Documentation

Poor Documentation Example
"Patient complains of sweating."
Good Documentation Example
"Primary focal hyperhidrosis (L74.512) with HDSS 4: Sweat drips from palms during handshakes, requiring hourly towel use."
Explanation
The good example provides specific location, severity, and impact on daily life, supporting medical necessity.

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