ICD-10 Coding for Hormone Imbalance(E28.2, E29.1, E23.0)
Complete ICD-10-CM coding and documentation guide for Hormone Imbalance. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hormone Imbalance
Disorders of thyroid gland
Includes thyroid-related hormone imbalances such as hypothyroidism.
E20-E35Primary Range
Disorders of other endocrine glands
Covers a wide range of hormone imbalances including pituitary, adrenal, and gonadal disorders.
Postprocedural endocrine and metabolic complications and disorders
Includes hormone imbalances resulting from surgical procedures.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E28.2 | Polycystic ovarian syndrome | Use when PCOS is confirmed by clinical and laboratory findings. |
|
| E29.1 | Testicular hypofunction | Use when testicular hypofunction is confirmed by low testosterone levels. |
|
| E23.0 | Hypopituitarism | Use when hypopituitarism is confirmed by ACTH stimulation test. |
|
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 hormone imbalance
Essential facts and insights about Hormone Imbalance
Primary ICD-10-CM Codes for hormone imbalance
Decision Criteria
clinical Criteria
- Presence of polycystic ovaries and oligomenorrhea
Applicable To
- Polycystic ovaries
- Oligomenorrhea
Excludes
- Primary ovarian failure (E28.3)
Clinical Validation Requirements
- Elevated LH:FSH ratio
- Ultrasound confirmation of polycystic ovaries
Code-Specific Risks
- Misclassification if not confirmed by ultrasound
Coding Notes
- Ensure documentation includes both clinical and laboratory findings.
E29.1 - Testicular hypofunction
Use when testicular hypofunction is confirmed by low testosterone levels.
Applicable To
- Low testosterone
- Hypogonadism
Excludes
- Postprocedural hypogonadism (E89.5)
Clinical Validation Requirements
- Testosterone levels below 300 ng/dL
- Clinical symptoms of hypogonadism
Coding Notes
Ensure testosterone levels are documented in the patient's record.
E23.0 - Hypopituitarism
Use when hypopituitarism is confirmed by ACTH stimulation test.
Applicable To
- Pituitary insufficiency
Excludes
- Isolated ACTH deficiency (E27.3)
Clinical Validation Requirements
- ACTH stimulation test results
- Low cortisol and low ACTH levels
Coding Notes
Document results of ACTH stimulation test and relevant hormone levels.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hormone Imbalance to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E28.2.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Increases risk of audit., Financial: Potential for denied claims.
Mitigation Strategy
Confirm diagnosis with lab tests, Use specific codes
Impact
Reimbursement: May result in lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Decreases accuracy of healthcare data.
Mitigation Strategy
Ensure specific diagnosis is documented and coded.
Impact
High risk of audit when using codes like E34.9 without specific diagnosis.
Mitigation Strategy
Ensure all diagnoses are supported by clinical 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 Hormone Imbalance, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hormone Imbalance
Use these documentation templates to ensure complete and accurate documentation for Hormone Imbalance. These templates include all required elements for proper coding and billing.
Patient with suspected PCOS
Specialty: EndocrinologyRequired Elements
- Clinical symptoms
- Laboratory findings
- Imaging results
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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