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ICD-10 Guide
DiagnosesAdrenal Adenoma

Adrenal Adenoma

ICD-10 Coding for Adrenal Adenoma(D35.00)

PRIMARY SPECIALTYEndocrinology
COMPLEXITYHigh
LAST UPDATED09/15/2025
Sam Tuffun, PT, DPT
Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Adrenal Adenoma?
Essential facts and insights about Adrenal Adenoma

Key Clinical Considerations:

  • Patients may present with symptoms such as hypertension, hypokalemia, or adrenal insufficiency.
  • Laboratory findings may include elevated serum cortisol levels, suppressed ACTH levels, and abnormal dexamethasone suppression test results.
  • Physical examination may reveal signs of Cushing's syndrome, such as obesity, purple striae, and hirsutism.
  • Imaging findings typically include unilateral adrenal mass on CT or MRI, often with attenuation values consistent with adenoma.
  • Severity criteria may involve the size of the adenoma (>4 cm may indicate a higher risk of malignancy) and associated hormonal activity.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the patient's symptoms, laboratory results, imaging findings, and treatment plans.
  • Specific terminology such as 'adrenal adenoma', 'hyperaldosteronism', or 'Cushing's syndrome' must be used.
  • Documentation examples include noting the size of the adenoma and any hormonal assays performed.
  • Medical necessity must be established through documentation of symptoms and the need for diagnostic testing.
  • Quality measures may include tracking outcomes related to surgical interventions or medical management.

Coding Guidelines

Usage Guidelines & Examples

  • Use D35.00 for a benign adrenal tumor when the adenoma is confirmed and symptomatic.
  • Do NOT use this code for adrenal carcinoma or other malignant tumors; use C74.9 instead.
  • Similar codes include D35.01 for aldosterone-producing adenoma and D35.02 for cortisol-producing adenoma.
  • Common errors include misclassifying adrenal adenomas as malignant or failing to document the size of the adenoma.
  • In complex cases, consider additional codes for associated conditions like hypertension or diabetes.

Code Exclusions

Important Exclusions

  • Excludes adrenal carcinoma (C74.9) and pheochromocytoma (C74.4).
  • Alternative codes for excluded conditions include C74.9 for malignant adrenal tumors.
  • Conditions are excluded due to differences in treatment protocols and prognosis.
  • Common mistakes include coding adrenal adenoma when the patient has a malignant tumor.
  • Related but distinct conditions include adrenal hyperplasia and adrenal cysts.

Related ICD-10 Codes

Primary Codes
D35.00
Benign neoplasm of unspecified adrenal gland
D35.01
Aldosterone-producing adenoma
Ancillary Codes
E24.0
Differential Codes
C74.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Endocrinology

Specialty Applications

  • Applies to patients with adrenal tumors, particularly those presenting with hormonal symptoms.
  • Patient populations include adults, with a higher prevalence in females aged 30-50.
  • Clinical settings include outpatient endocrinology clinics and inpatient surgical units.
  • Specialty-specific applications are relevant in endocrinology and oncology.
  • Treatment contexts include surgical resection or medical management of hyperaldosteronism.

Coding Complexity

High Complexity

This diagnosis requires careful attention to:

  • Comprehensive clinical documentation
  • Accurate code selection based on clinical criteria
  • Proper exclusion considerations
  • Specialty-specific coding guidelines

Documentation

Documentation Templates

Template 1

Template: 'Patient diagnosed with adrenal adenoma based on imaging findings and elevated cortisol levels.'

Template 2

Template: 'Clinical presentation consistent with adrenal adenoma including hypertension and hypokalemia.'

Template 3

Template: 'Diagnostic criteria met as evidenced by imaging showing a unilateral adrenal mass.'

Template 4

Template: 'Treatment plan initiated for adrenal adenoma with surgical intervention planned.'

Template 5

Template: 'Follow-up care for adrenal adenoma including monitoring of cortisol levels and blood pressure.'

Billing Information

Billing Considerations

  • Ensure proper documentation for billing
  • Verify code specificity requirements
  • Check for any additional codes needed
  • Review payer-specific guidelines

Common Issues

  • Insufficient clinical documentation
  • Incorrect code selection
  • Missing supporting diagnoses
  • Timing and frequency documentation

Frequently Asked Questions

What documentation is required for this diagnosis?

Documentation must include clinical findings, imaging results, and treatment plans.

How does this differ from similar diagnoses?

Adrenal adenoma is benign, while adrenal carcinoma is malignant, requiring different management.

What are common billing considerations?

Ensure documentation supports medical necessity and includes all relevant tests and treatments.

What procedures are typically associated?

Commonly associated procedures include adrenalectomy and hormonal assays.

Are there any quality reporting implications?

Quality measures may include tracking surgical outcomes and management of associated conditions.