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ICD-10 Guide
ICD-10 CodesE24.3

E24.3

Billable

Ectopic ACTH syndrome

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

Code Description

ICD-10 E24.3 is a billable code used to indicate a diagnosis of ectopic acth syndrome.

Key Diagnostic Point:

Ectopic ACTH syndrome is a rare endocrine disorder characterized by the production of adrenocorticotropic hormone (ACTH) from non-pituitary tumors, leading to excessive cortisol production by the adrenal glands. This condition is often associated with malignancies, particularly small cell lung cancer, but can also arise from other neoplasms such as carcinoid tumors and pancreatic tumors. The ectopic secretion of ACTH results in Cushing's syndrome, which manifests with symptoms such as obesity, hypertension, diabetes mellitus, and skin changes. Diagnosis typically involves biochemical tests to measure cortisol and ACTH levels, imaging studies to identify the source of ectopic ACTH production, and possibly a biopsy of the tumor. Management may include surgical resection of the tumor, medical therapy to control cortisol levels, and treatment of the underlying malignancy. Understanding the interplay between the adrenal glands, pituitary gland, and the tumors responsible for ectopic ACTH production is crucial for effective diagnosis and treatment.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Differentiating between ectopic ACTH syndrome and other causes of Cushing's syndrome.
  • Identifying the primary tumor source, which may require extensive imaging.
  • Variability in clinical presentation based on the underlying malignancy.
  • Need for comprehensive documentation of hormone levels and imaging results.

Audit Risk Factors

  • Inadequate documentation of the tumor type and location.
  • Failure to document the biochemical confirmation of ACTH levels.
  • Misclassification of the syndrome as primary adrenal insufficiency.
  • Lack of clarity in the treatment plan and follow-up care.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed hormone level assessments, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with symptoms of Cushing's syndrome and abnormal ACTH levels.

Billing Considerations

Ensure accurate documentation of all endocrine evaluations and multidisciplinary consultations.

Oncology

Documentation Requirements

Pathology reports, imaging results, and treatment protocols for the underlying malignancy.

Common Clinical Scenarios

Patients with known malignancies presenting with signs of hypercortisolism.

Billing Considerations

Document the relationship between the tumor and ectopic ACTH production clearly.

Coding Guidelines

Inclusion Criteria

Use E24.3 When
  • According to ICD
  • 10 guidelines, E24
  • 3 should be used when there is clear documentation of ectopic ACTH production leading to Cushing's syndrome
  • It is important to include the underlying malignancy when applicable, and to ensure that all diagnostic criteria are met

Exclusion Criteria

Do NOT use E24.3 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

83520CPT Code

Cortisol level test

Clinical Scenario

Used to confirm hypercortisolism in suspected cases of ectopic ACTH syndrome.

Documentation Requirements

Document the reason for the test and the clinical findings leading to it.

Specialty Considerations

Endocrinologists should ensure comprehensive hormone evaluations are included.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of ectopic ACTH syndrome, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better understanding the epidemiology and management of the condition.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of ectopic ACTH syndrome, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better understanding the epidemiology and management of the condition.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of ectopic ACTH syndrome, improving the accuracy of diagnosis and treatment tracking. This specificity aids in better understanding the epidemiology and management of the condition.

Resources

Clinical References

  • •
    Endocrine Society Guidelines

Coding & Billing References

  • •
    Endocrine Society Guidelines

Frequently Asked Questions

What is ectopic ACTH syndrome?

Ectopic ACTH syndrome is a condition where non-pituitary tumors produce ACTH, leading to excess cortisol production and symptoms of Cushing's syndrome.

How is ectopic ACTH syndrome diagnosed?

Diagnosis involves measuring serum cortisol and ACTH levels, imaging studies to locate the tumor, and possibly a biopsy.

What are the common causes of ectopic ACTH syndrome?

Common causes include small cell lung cancer, carcinoid tumors, and pancreatic tumors.