ICD-10 Coding for Prolactin Disorders(E22.1)
Complete ICD-10-CM coding and documentation guide for Prolactin Disorders. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Prolactin Disorders
E22.0-E23.7Primary Range
Disorders of pituitary gland
Includes primary codes for prolactin disorders such as hyperprolactinemia.
Hypertensive heart and chronic kidney disease
Relevant for conditions that may cause secondary hyperprolactinemia.
Key Information: ICD-10 code for hyperprolactinemia
Essential facts and insights about Prolactin Disorders
Primary ICD-10-CM Code for prolactin
Decision Criteria
clinical Criteria
- Prolactin level >25 µg/L with symptoms like galactorrhea.
documentation Criteria
- MRI findings of pituitary adenoma.
Applicable To
- Idiopathic hyperprolactinemia
- Pituitary-related hyperprolactinemia
Excludes
- Suppressed lactation (O92.5)
Clinical Validation Requirements
- Prolactin level >25 µg/L in non-pregnant individuals
- MRI confirmation of pituitary adenoma
Code-Specific Risks
- Incorrect use without documented etiology
- Failure to document MRI findings
Coding Notes
- Ensure documentation of prolactin levels and imaging studies.
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.
Suppressed lactation
O92.5Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Prolactin Disorders 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 diagnosis of pituitary disorders., Regulatory: Non-compliance with documentation standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure MRI reports are included in patient records., Verify documentation before coding.
Impact
Reimbursement: May lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data.
Mitigation Strategy
Always document the underlying cause of hyperprolactinemia.
Impact
Failure to document the cause of hyperprolactinemia can lead to audit issues.
Mitigation Strategy
Always include detailed etiology in patient records.
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 Prolactin Disorders, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Prolactin Disorders
Use these documentation templates to ensure complete and accurate documentation for Prolactin Disorders. These templates include all required elements for proper coding and billing.
Endocrinology evaluation for hyperprolactinemia
Specialty: EndocrinologyRequired Elements
- Patient history
- Prolactin levels
- MRI results
- Medication history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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