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v1.0.0
ICD-10 Guide
DiagnosesAdrenal Nodule

Adrenal Nodule

ICD-10 Coding for Adrenal Nodule(E27.8, D35.0, D35.01, D35.02, C74.9)

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

Diagnosis Overview

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

Key Clinical Considerations:

  • Presence of an adrenal nodule may be asymptomatic or present with symptoms such as abdominal pain, hypertension, or hormonal imbalances.
  • Laboratory findings may include abnormal hormone levels (e.g., cortisol, aldosterone) depending on the type of nodule (functional vs. non-functional).
  • Physical examination may reveal signs of Cushing's syndrome or other endocrine disorders if the nodule is functional.
  • Imaging findings typically include CT or MRI scans showing the size, shape, and characteristics of the adrenal nodule.
  • Severity criteria may involve the size of the nodule (e.g., >4 cm may raise suspicion for malignancy) and functional status.

Clinical Information

Clinical Criteria & Documentation Requirements

  • Medical records must document the size, location, and characteristics of the adrenal nodule.
  • Specific terminology such as 'adrenal adenoma', 'adrenal carcinoma', or 'incidentaloma' must be used appropriately.
  • Examples include noting the imaging results, laboratory findings, and any symptoms experienced by the patient.
  • Documentation must establish medical necessity for imaging and any subsequent interventions.
  • Quality measures may include tracking the follow-up of incidental findings and management of functional nodules.

Coding Guidelines

Usage Guidelines & Examples

  • Use E27.8 for unspecified adrenal disorders, D35.0 for benign neoplasm of the adrenal gland, and C74.9 for malignant neoplasm when applicable.
  • Do not use these codes for conditions unrelated to adrenal nodules, such as primary adrenal insufficiency (E27.1).
  • D35.01 and D35.02 specify right and left adrenal adenomas, respectively, which are more specific than D35.0.
  • Common errors include misclassifying functional nodules as non-functional or vice versa; ensure clinical context is clear.
  • In complex cases, consider the patient's hormonal profile and imaging results to select the most accurate code.

Code Exclusions

Important Exclusions

  • Exclude conditions such as adrenal insufficiency (E27.1) and adrenal hemorrhage (E27.2) as they are distinct diagnoses.
  • Alternative codes for excluded conditions include E27.1 for adrenal insufficiency and E27.2 for adrenal hemorrhage.
  • Conditions are excluded due to differing pathophysiology and management strategies.
  • Common mistakes include coding adrenal nodules as adrenal insufficiency; ensure clinical context is clear.
  • Related but distinct conditions include adrenal cysts and adrenal hyperplasia.

Related ICD-10 Codes

Primary Codes
E27.8
Other specified disorders of adrenal gland
D35.0
Benign neoplasm of adrenal gland
D35.01
Benign neoplasm of right adrenal gland
D35.02
Benign neoplasm of left adrenal gland
C74.9
Malignant neoplasm of adrenal gland, unspecified
Ancillary Codes
E34.0
I10
E24.2
E26.9
Z85.03
Differential Codes
D35.0
D35.0
for confirmed benign neoplasms, not for hyperplasia.
C74.9
C74.9
for biopsy-confirmed malignancy.
C74.01
C74.01
for confirmed malignancy on the right side.
C74.02
C74.02
for confirmed malignancy on the left side.

Related CPT Codes

CPT codes will be available in a future update.

Specialty Focus

Primary Specialty

Radiology

Specialty Applications

  • This applies to patients with adrenal nodules, which may be functional or non-functional.
  • Patient populations include adults, with a higher prevalence in those over 50 years and those with a history of endocrine disorders.
  • Clinical settings include outpatient endocrinology clinics, inpatient hospital settings for surgical evaluation, and radiology departments for imaging.
  • Specialty-specific applications are relevant in endocrinology, radiology, and surgical oncology.
  • Treatment contexts may involve monitoring, surgical intervention, or hormonal therapy depending on the nodule's characteristics.

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 nodule based on imaging findings of [size] cm.'

Template 2

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

Template 3

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

Template 4

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

Template 5

Template: 'Follow-up care for adrenal nodule including monitoring of [hormonal levels or imaging].'

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 should include imaging results, size and characteristics of the nodule, and any hormonal evaluations.

How does this differ from similar diagnoses?

Adrenal nodules differ from adrenal insufficiency and adrenal carcinoma in terms of clinical presentation and management.

What are common billing considerations?

Ensure that the documentation supports the medical necessity for imaging and any interventions performed.

What procedures are typically associated?

Common procedures include CT or MRI imaging, and potential surgical interventions such as adrenalectomy.

Are there any quality reporting implications?

Quality measures may include tracking follow-up care for incidental findings and management of functional nodules.