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v1.0.0
ICD-10 Guide
ICD-10 CodesE21.0

E21.0

Billable

Primary hyperparathyroidism

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E21.0 is a billable code used to indicate a diagnosis of primary hyperparathyroidism.

Key Diagnostic Point:

Primary hyperparathyroidism (PHPT) is a condition characterized by the excessive secretion of parathyroid hormone (PTH) from the parathyroid glands, leading to elevated levels of calcium in the blood (hypercalcemia). This disorder is often caused by a benign tumor on one of the parathyroid glands (adenoma), hyperplasia of the glands, or, less commonly, parathyroid carcinoma. The condition can result in a variety of symptoms, including fatigue, weakness, depression, bone pain, kidney stones, and gastrointestinal disturbances. Diagnosis typically involves measuring serum calcium and PTH levels, and imaging studies may be used to identify any adenomas. Treatment often involves surgical removal of the affected gland(s), and management may also include monitoring and addressing complications such as osteoporosis and renal calculi. Understanding the interplay between parathyroid function and other endocrine glands, such as the pituitary and adrenal glands, is crucial, as hormone imbalances can lead to a range of systemic effects.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between primary, secondary, and tertiary hyperparathyroidism.
  • Understanding the relationship between calcium levels and PTH secretion.
  • Identifying the need for imaging studies to confirm diagnosis.
  • Documenting associated conditions such as osteoporosis or kidney stones.

Audit Risk Factors

  • Inadequate documentation of laboratory results.
  • Failure to document the specific type of hyperparathyroidism.
  • Lack of clarity on the presence of associated conditions.
  • Insufficient detail on treatment plans and follow-up.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Comprehensive lab results, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with hypercalcemia, bone pain, or kidney stones.

Billing Considerations

Ensure clear documentation of PTH levels and calcium status.

Surgery

Documentation Requirements

Operative reports detailing the surgical procedure and findings.

Common Clinical Scenarios

Patients undergoing parathyroidectomy for adenoma removal.

Billing Considerations

Document indications for surgery and pre-operative evaluations.

Coding Guidelines

Inclusion Criteria

Use E21.0 When
  • Follow official coding guidelines for endocrine disorders, ensuring accurate documentation of the condition's etiology and any associated complications
  • Include relevant lab results and imaging studies in the medical record

Exclusion Criteria

Do NOT use E21.0 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

60500CPT Code

Parathyroidectomy

Clinical Scenario

Used when a patient with primary hyperparathyroidism undergoes surgical removal of the affected parathyroid gland.

Documentation Requirements

Operative report detailing the procedure and findings.

Specialty Considerations

Endocrinologists and surgeons must coordinate documentation to ensure clarity.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of parathyroid disorders, improving the accuracy of diagnoses and treatment tracking. E21.0 provides a clear distinction from secondary causes, which aids in clinical management and reimbursement.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of parathyroid disorders, improving the accuracy of diagnoses and treatment tracking. E21.0 provides a clear distinction from secondary causes, which aids in clinical management and reimbursement.

Reimbursement & Billing Impact

reimbursement.

Resources

Clinical References

  • •
    American Association of Clinical Endocrinologists

Coding & Billing References

  • •
    American Association of Clinical Endocrinologists

Frequently Asked Questions

What are the common symptoms of primary hyperparathyroidism?

Common symptoms include fatigue, weakness, depression, bone pain, kidney stones, and gastrointestinal issues such as nausea and constipation.

How is primary hyperparathyroidism diagnosed?

Diagnosis is typically made through blood tests showing elevated calcium and parathyroid hormone levels, along with imaging studies to identify any adenomas.