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ESRD and Secondary Hyperparathyroidism

Parul Posted Mon 20th of August, 2018 14:22:02 PM
Can we report ICD-10-CM code N25.81 for Secondary Hyperparathyroidism of renal origin when the documentation states "HTN with ESRD, secondary hyperparathyroidism"? Does the documentation need to clearly link secondary hyperparathyroidism to ESRD? ICD-10-CM presumes a cause-and-effect relationship, and classifies CKD with hypertension as hypertensive chronic kidney disease ( ICD-10-CM Official Guidelines for Coding and Reporting FY 2018 see Section I.C.9. Hypertensive Chronic Kidney Disease). Can a similar cause-and-effect relationship be assumed between ESRD and secondary hyperparathyroidism? I am not able to find any resource that specifically states documentation needs to explicitly link Secondary Hyperparathyroidism with ESRD. Kindly advise.
SuperCoder Answered Tue 21st of August, 2018 08:18:58 AM


According to the classification of ICD 10 codes for secondary hyperparathyroidism, the codes direct to the renal and non-renal origin of secondary hyperparathyroidism. In addition, Hyperparathyroidism is a condition which results in abnormal electrolyte levels, frequently noted on screening labs. Secondary hyperparathyroidism is commonly noted with CKD and should be properly diagnosed so disease modifying agents can be started.  So, as per above mentioned documentation, patient is suffering from CKD, hence the appropriate ICD 10 code will be N25.81.

Good day.

Parul Posted Wed 22nd of August, 2018 09:00:56 AM
Thank you for this information. I would like additional clarification. Does the documentation need to explicitly state that the secondary hyperparathyroidism is due to renal origin? Current documentation just states ESRD and secondary hyperparathyroidism.
SuperCoder Answered Thu 23rd of August, 2018 07:03:14 AM

Hi Parul,

Since the code depends on the renal and non-renal origin, the documentation should clearly state the cause of hyperparathyroidism (clearly stated here as ESRD).




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