ICD-10 Guide

Acromegaly

ICD-10 Coding for Acromegaly(E22.0)

PRIMARY SPECIALTYEndocrinology

COMPLEXITYHigh

LAST UPDATED09/15/2025

Sam Tuffun, PT, DPT

Physical Therapist | Medical Coding & Billing Contributor

Diagnosis Overview

What is Acromegaly?

Acromegaly is a hormonal disorder that results from excess growth hormone (GH) production, typically due to a benign pituitary adenoma. This condition leads to abnormal growth of bones and soft tissues, particularly noticeable in the hands, feet, and face. Key clinical points include: 1) Gradual onset of symptoms, often over several years; 2) Common signs include enlarged hands and feet, facial changes, and joint pain; 3) Associated complications may include diabetes, hypertension, and cardiovascular disease. The etiology primarily involves pituitary tumors, while the pathophysiology centers on the overproduction of GH, leading to increased insulin-like growth factor 1 (IGF-1) levels. Clinical presentation often includes noticeable changes in physical appearance and metabolic disturbances, necessitating timely diagnosis and management.

Key Clinical Considerations:

Diagnosis requires clinical evidence of elevated growth hormone and IGF-1 levels, along with characteristic physical changes.
Signs and symptoms include enlarged extremities, facial changes (e.g., prognathism), and joint pain.
Resolution criteria may include normalization of GH and IGF-1 levels post-treatment.
Imaging findings such as MRI may reveal pituitary adenomas, supporting the diagnosis.

Clinical Information

Clinical Criteria & Documentation Requirements

Documentation must include clinical findings, laboratory results, and imaging studies that support the diagnosis.
Compliant documentation examples include detailed descriptions of symptoms and laboratory results; non-compliant examples lack specificity.
Template phrases: 'Patient diagnosed with acromegaly based on elevated IGF-1 levels and MRI findings of a pituitary adenoma.'
Medical necessity documentation should justify the need for diagnostic tests and treatment plans.

Coding Guidelines

Usage Guidelines & Examples

Use E22.0 when diagnosing acromegaly confirmed by clinical and laboratory findings; for example, a patient with characteristic symptoms and elevated IGF-1 levels.
Do not use this code for other growth disorders not related to excess GH, such as gigantism in children.
Correct usage example: 'Acromegaly due to pituitary adenoma'; incorrect usage: 'Generalized growth disorder'.
Common errors include misdiagnosing acromegaly as other conditions; ensure thorough evaluation of symptoms and lab results.

Code Exclusions

Important Exclusions

Excluded conditions include other forms of pituitary dysfunction not related to GH excess, such as Cushing's disease.
Alternative codes for exclusions may include E22.2 for other pituitary disorders.
Common exclusion errors involve misclassifying other growth disorders as acromegaly; ensure accurate clinical assessment.
Certain conditions are excluded to maintain specificity in coding and avoid reimbursement issues.

Specialty Focus

Primary Specialty

Endocrinology

Specialty Applications

This diagnosis applies to adults presenting with signs of acromegaly.
Appropriate in clinical scenarios where patients exhibit characteristic symptoms and laboratory findings.
Applicable in both outpatient and inpatient settings, particularly in endocrinology practices.
Specialty-specific considerations include the need for endocrinologists to evaluate and manage the condition.

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: 'Acromegaly diagnosed based on elevated IGF-1 levels and MRI findings.'

Template 2

Template: 'Patient presents with enlarged hands and facial changes consistent with acromegaly.'

Template 3

Template: 'Diagnostic criteria met: elevated GH and IGF-1 levels, MRI showing pituitary adenoma.'

Template 4

Template: 'Treatment plan includes surgical intervention and monitoring of GH levels for acromegaly.'

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 code?

Detailed documentation of symptoms, lab results (GH and IGF-1 levels), and imaging findings.

When should this code be used vs similar codes?

Use E22.0 specifically for acromegaly; use E22.1 for acromegaly due to excess GH.

What are common billing issues with this code?

Reimbursement issues may arise from insufficient documentation; ensure all clinical findings are well-documented.

What procedures are commonly associated?

Related CPT codes include pituitary tumor resection and GH suppression tests.

What is Acromegaly?

Key Clinical Considerations:

Diagnosis requires clinical evidence of elevated growth hormone and IGF-1 levels, along with characteristic physical changes.
Signs and symptoms include enlarged extremities, facial changes (e.g., prognathism), and joint pain.
Resolution criteria may include normalization of GH and IGF-1 levels post-treatment.
Imaging findings such as MRI may reveal pituitary adenomas, supporting the diagnosis.

Acromegaly

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Template 1

Template 2

Template 3

Template 4

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What documentation is required for this code?

When should this code be used vs similar codes?

What are common billing issues with this code?

What procedures are commonly associated?

Acromegaly

Diagnosis Overview

Key Clinical Considerations:

Clinical Information

Clinical Criteria & Documentation Requirements

Coding Guidelines

Usage Guidelines & Examples

Code Exclusions

Important Exclusions

Related ICD-10 Codes

Related CPT Codes

Specialty Focus

Primary Specialty

Specialty Applications

Coding Complexity

Documentation

Documentation Templates

Template 1

Template 2

Template 3

Template 4

Billing Information

Billing Considerations

Common Issues

Frequently Asked Questions

What documentation is required for this code?

When should this code be used vs similar codes?

What are common billing issues with this code?

What procedures are commonly associated?