Secondary hyperparathyroidism, not elsewhere classified
ICD-10 E21.1 is a billable code used to indicate a diagnosis of secondary hyperparathyroidism, not elsewhere classified.
Secondary hyperparathyroidism is a condition characterized by an increase in parathyroid hormone (PTH) levels due to a chronic underlying condition, most commonly chronic kidney disease (CKD). In CKD, the kidneys are unable to adequately excrete phosphate, leading to hyperphosphatemia, which in turn stimulates the parathyroid glands to produce more PTH in an attempt to maintain calcium homeostasis. This compensatory mechanism can result in parathyroid gland hyperplasia and elevated serum PTH levels. Unlike primary hyperparathyroidism, where the parathyroid glands are autonomously overactive, secondary hyperparathyroidism is a response to external stimuli, such as low serum calcium or high phosphate levels. The condition can lead to bone disease, cardiovascular complications, and other systemic effects if not managed appropriately. Diagnosis typically involves serum calcium, phosphate, and PTH level assessments, alongside imaging studies to evaluate bone health. Treatment focuses on managing the underlying cause, often involving dietary phosphate restriction, phosphate binders, and vitamin D analogs to help control PTH levels.
Detailed lab results, treatment plans, and patient history related to calcium and phosphate metabolism.
Patients with chronic kidney disease presenting with elevated PTH levels.
Ensure comprehensive documentation of all endocrine evaluations and treatments.
Documentation of kidney function tests, phosphate levels, and management strategies for CKD.
Patients undergoing dialysis with associated bone mineral disorders.
Document the relationship between kidney function and parathyroid hormone levels.
Used to assess electrolyte levels including calcium and phosphate.
Document all lab results and their relevance to the diagnosis.
Endocrinologists should ensure lab results are interpreted in the context of endocrine function.
The primary cause is usually chronic kidney disease, which leads to imbalances in calcium and phosphate metabolism.
Management typically involves treating the underlying kidney disease, dietary phosphate restriction, and medications to control PTH levels.
