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ICD-10 Guide
DiagnosesAdrenal Lesion

Adrenal Lesion

ICD-10 Coding for Adrenal Lesion(E27.8, D35.0)

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

Diagnosis Overview

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

Key Clinical Considerations:

  • Presence of an adrenal mass identified through imaging studies such as CT or MRI.
  • Symptoms may include hypertension, unexplained weight gain, or changes in hair distribution.
  • Physical examination may reveal signs of Cushing's syndrome or other hormonal imbalances.
  • Imaging findings may show unilateral or bilateral adrenal lesions, with characteristics such as size, density, and enhancement patterns.
  • Severity criteria may include the size of the lesion (>4 cm may indicate a higher risk of malignancy) and functional status (hormone-secreting vs. non-secreting).

Clinical Information

Clinical Criteria & Documentation Requirements

  • Complete medical history including symptoms, duration, and any previous imaging results.
  • Specific terminology such as 'adrenal adenoma', 'adrenal carcinoma', or 'incidentaloma' must be documented.
  • Examples include: 'CT scan shows a 3 cm adrenal mass consistent with adenoma.'
  • Documentation must demonstrate medical necessity for imaging and any subsequent interventions.
  • Quality measures may include documentation of follow-up imaging or laboratory tests to monitor hormone levels.

Coding Guidelines

Usage Guidelines & Examples

  • Use E27.8 for unspecified adrenal disorders when the specific nature of the lesion is not determined.
  • Do NOT use this code for adrenal insufficiency or other endocrine disorders not related to lesions.
  • D35.0 is used for benign neoplasms of the adrenal gland; differentiate based on imaging and pathology results.
  • Common errors include using the wrong code for functional vs. non-functional lesions; ensure clarity in documentation.
  • In complex cases, consider the patient's clinical presentation and imaging findings to select the most accurate code.

Code Exclusions

Important Exclusions

  • Excludes conditions such as adrenal insufficiency (E27.4) or adrenal hemorrhage (E27.5).
  • Alternative codes for excluded conditions include E27.4 for adrenal insufficiency or C74.9 for malignant neoplasm.
  • Conditions are excluded based on the presence of specific symptoms or imaging findings that do not indicate a lesion.
  • Common mistakes include misclassifying adrenal lesions as benign when they are functional or malignant.
  • Related but distinct conditions include adrenal hyperplasia (E27.1) and primary aldosteronism (E26.0).

Related ICD-10 Codes

Primary Codes
E27.8
Other specified disorders of the adrenal gland
D35.0
Benign neoplasm of the adrenal gland
Differential Codes
D35.0
C74.0

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Radiology

Specialty Applications

  • Conditions such as adrenal adenoma, adrenal carcinoma, or incidental adrenal masses.
  • Patient populations may include adults aged 30-60, with risk factors such as obesity or family history of endocrine tumors.
  • Clinical settings include outpatient endocrinology clinics, inpatient hospital settings, and emergency departments.
  • Specialty-specific applications are relevant in endocrinology, oncology, and radiology.
  • Treatment contexts may involve surgical intervention, hormonal therapy, or active surveillance.

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 lesion based on imaging findings of [specific characteristics].'

Template 2

Template: 'Clinical presentation consistent with adrenal adenoma including symptoms of [specific symptoms].'

Template 3

Template: 'Diagnostic criteria met as evidenced by imaging showing [specific findings].'

Template 4

Template: 'Treatment plan initiated for adrenal lesion with [specific interventions].'

Template 5

Template: 'Follow-up care for adrenal lesion including monitoring of [specific parameters].'

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?

Detailed imaging reports, clinical notes, and laboratory results supporting the diagnosis.

How does this differ from similar diagnoses?

Differentiation is based on imaging characteristics and hormonal activity of the lesion.

What are common billing considerations?

Ensure that the diagnosis supports the medical necessity for imaging and any procedures performed.

What procedures are typically associated?

CPT codes for adrenalectomy, imaging studies, and hormone level testing are commonly associated.

Are there any quality reporting implications?

Quality measures may include follow-up imaging and monitoring of hormone levels post-diagnosis.