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ICD-10 Guide
ICD-10 CodesE26.09

E26.09

Billable

Other primary hyperaldosteronism

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

Code Description

ICD-10 E26.09 is a billable code used to indicate a diagnosis of other primary hyperaldosteronism.

Key Diagnostic Point:

Other primary hyperaldosteronism refers to conditions characterized by excessive production of aldosterone from the adrenal glands, leading to hypertension and electrolyte imbalances. This condition can arise from various adrenal disorders, including adrenal adenomas, bilateral adrenal hyperplasia, or other rare causes. Aldosterone plays a crucial role in regulating sodium and potassium levels in the body, and its overproduction can result in sodium retention, potassium loss, and increased blood volume, ultimately causing hypertension. Patients may present with symptoms such as muscle weakness, fatigue, and headaches due to electrolyte imbalances. Diagnosis typically involves measuring plasma aldosterone levels, plasma renin activity, and conducting imaging studies to identify adrenal abnormalities. Treatment options may include mineralocorticoid receptor antagonists, surgical intervention for adrenal tumors, or lifestyle modifications to manage hypertension. Accurate coding is essential for proper reimbursement and to reflect the complexity of the patient's condition.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Variety of underlying causes leading to hyperaldosteronism
  • Need for differential diagnosis to rule out other conditions
  • Potential for co-existing endocrine disorders
  • Variability in clinical presentation among patients

Audit Risk Factors

  • Inadequate documentation of laboratory results
  • Failure to specify the underlying cause of hyperaldosteronism
  • Misclassification of primary vs. secondary hyperaldosteronism
  • Lack of detailed clinical notes regarding symptoms and treatment

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed endocrine evaluation, including hormone levels and imaging studies.

Common Clinical Scenarios

Patients presenting with hypertension and hypokalemia, requiring assessment for hyperaldosteronism.

Billing Considerations

Endocrinologists must ensure comprehensive documentation of all hormonal assays and imaging results to support the diagnosis.

Internal Medicine

Documentation Requirements

Thorough history and physical examination, including blood pressure readings and electrolyte levels.

Common Clinical Scenarios

Management of patients with resistant hypertension and suspected hyperaldosteronism.

Billing Considerations

Internists should document any referrals to endocrinology or nephrology for further evaluation.

Coding Guidelines

Inclusion Criteria

Use E26.09 When
  • According to ICD
  • 10 guidelines, E26
  • 09 should be used when the specific cause of primary hyperaldosteronism is not classified elsewhere
  • Coders must ensure that the diagnosis is supported by appropriate laboratory and imaging documentation

Exclusion Criteria

Do NOT use E26.09 When
  • Exclusion criteria include secondary causes of hyperaldosteronism, which must be coded separately

Related ICD-10 Codes

Related CPT Codes

84144CPT Code

Aldosterone, plasma

Clinical Scenario

Used to confirm diagnosis of hyperaldosteronism.

Documentation Requirements

Document the reason for the test and the patient's clinical presentation.

Specialty Considerations

Endocrinologists should ensure that lab results are clearly linked to the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like primary hyperaldosteronism, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like primary hyperaldosteronism, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like primary hyperaldosteronism, improving the accuracy of diagnoses and treatment plans. This specificity aids in better tracking of patient outcomes and resource allocation.

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 hyperaldosteronism?

Common symptoms include hypertension, muscle weakness, fatigue, and frequent urination due to electrolyte imbalances.

How is primary hyperaldosteronism diagnosed?

Diagnosis typically involves measuring plasma aldosterone levels, plasma renin activity, and imaging studies to identify adrenal abnormalities.

What treatment options are available for primary hyperaldosteronism?

Treatment may include mineralocorticoid receptor antagonists, surgical removal of adrenal tumors, or lifestyle modifications to manage hypertension.