ICD-10 Coding for Hyperprolactinemia(E22.1)
Complete ICD-10-CM coding and documentation guide for Hyperprolactinemia. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperprolactinemia
E22-E22.9Primary Range
Hyperfunction of pituitary gland
This range includes hyperprolactinemia and related pituitary disorders.
Benign neoplasm of other and unspecified endocrine glands
Includes prolactinoma, a common cause of hyperprolactinemia.
Poisoning by, adverse effect of and underdosing of drugs, medicaments and biological substances
Includes drug-induced hyperprolactinemia.
Key Information: ICD-10 code for hyperprolactinemia
Essential facts and insights about Hyperprolactinemia
Primary ICD-10-CM Code for hyperprolactinemia
Decision Criteria
clinical Criteria
- Prolactin level >700 mIU/L with symptoms
coding Criteria
- Exclude drug-induced causes before using E22.1
Applicable To
- Idiopathic hyperprolactinemia
Excludes
- Drug-induced hyperprolactinemia (T38.8X5A)
Clinical Validation Requirements
- Prolactin levels >700 mIU/L
- Symptoms such as amenorrhea, galactorrhea
Code-Specific Risks
- Misclassification if cause is not specified
Coding Notes
- Ensure etiology is documented to avoid incorrect coding.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Adverse effect of other drugs, medicaments and biological substances
T38.8X5ADifferential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Benign neoplasm of pituitary gland
D35.2Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hyperprolactinemia to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E22.1.
Impact
Clinical: May lead to inappropriate treatment., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Always document the cause of hyperprolactinemia., Use templates to ensure completeness.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data recording.
Mitigation Strategy
Use T38.8X5A for drug-induced hyperprolactinemia.
Impact
Inadequate documentation of hyperprolactinemia causes.
Mitigation Strategy
Implement standardized documentation templates.
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 Hyperprolactinemia, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperprolactinemia
Use these documentation templates to ensure complete and accurate documentation for Hyperprolactinemia. These templates include all required elements for proper coding and billing.
Endocrinology evaluation for hyperprolactinemia
Specialty: EndocrinologyRequired Elements
- Patient history
- Lab results
- Imaging findings
- Etiology
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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