Cushing's syndrome
Chapter 4:Endocrine, nutritional and metabolic diseases
ICD-10 E24 is a billable code used to indicate a diagnosis of cushing's syndrome.
Cushing's syndrome is a complex endocrine disorder characterized by excessive levels of cortisol in the blood, which can result from various causes, including pituitary adenomas (Cushing's disease), adrenal tumors, or ectopic ACTH production. The condition leads to a range of symptoms, including obesity, particularly around the trunk and face (moon facies), skin changes such as easy bruising and striae, hypertension, diabetes mellitus, and osteoporosis. The underlying pathophysiology involves dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, leading to hypercortisolism. Diagnosis typically involves biochemical tests to measure cortisol levels, including 24-hour urinary free cortisol, late-night salivary cortisol, and suppression tests. Imaging studies may be necessary to identify the source of excess cortisol production. Management often requires surgical intervention, pharmacotherapy, or radiation therapy, depending on the etiology of the syndrome. Accurate coding is essential for appropriate treatment and reimbursement.
Detailed documentation of hormone levels, imaging studies, and treatment plans.
Diagnosis and management of Cushing's syndrome, including differential diagnosis from other endocrine disorders.
Ensure clarity in the documentation of the cause of hypercortisolism and any associated complications.
Operative reports detailing the surgical approach and findings.
Surgical intervention for adrenal tumors or pituitary adenomas causing Cushing's syndrome.
Document the rationale for surgery and any preoperative assessments performed.
Used when adrenal tumors are suspected in patients with Cushing's syndrome.
Pathology report and clinical notes detailing the indication for biopsy.
Endocrinology and pathology must collaborate for accurate diagnosis.
Cushing's syndrome can be caused by pituitary adenomas (Cushing's disease), adrenal tumors, or ectopic ACTH production from tumors elsewhere in the body. Exogenous causes include long-term use of glucocorticoid medications.
