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ICD-10 Guide
ICD-10 CodesL74.5

L74.5

Non-billable

Focal hyperhidrosis

BILLABLE STATUSNo
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/06/2025

Code Description

ICD-10 L74.5 is a used to indicate a diagnosis of focal hyperhidrosis.

Key Diagnostic Point:

Focal hyperhidrosis is a condition characterized by excessive sweating localized to specific areas of the body, such as the palms, soles, axillae, or face. This condition is often idiopathic, meaning the exact cause is unknown, but it may be linked to genetic factors, hormonal changes, or autonomic nervous system dysfunction. Clinically, patients present with episodes of excessive sweating that can occur spontaneously or be triggered by stress, heat, or physical activity. The anatomy involved includes eccrine sweat glands, which are densely concentrated in the affected areas. Disease progression can vary; while some individuals may experience symptoms throughout their lives, others may find that symptoms diminish with age. Diagnostic considerations include a thorough patient history, physical examination, and potentially the use of quantitative sudomotor axon reflex test (QSART) to measure sweat production. It is essential to differentiate focal hyperhidrosis from secondary causes of hyperhidrosis, such as endocrine disorders or infections, to ensure appropriate management.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Diagnostic complexity
  • Treatment complexity
  • Documentation requirements
  • Coding specificity

Audit Risk Factors

  • Common coding errors include misclassifying generalized hyperhidrosis as focal.
  • Documentation gaps may arise from insufficient detail in patient history or treatment response.
  • Billing challenges can occur if the treatment plan is not clearly outlined or if the diagnosis is not well-supported.

Specialty Focus

Medical Specialties

Dermatology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Endocrinology

Documentation Requirements

Standard ICD-10-CM documentation requirements apply

Common Clinical Scenarios

Various clinical presentations within this specialty area

Billing Considerations

Follow specialty-specific billing guidelines

Related ICD-10 Codes

Related CPT Codes

CPT Code

Clinical Scenario

Documentation Requirements

CPT Code

Clinical Scenario

Documentation Requirements

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

Focal hyperhidrosis can significantly affect a patient's quality of life, leading to social anxiety, decreased productivity, and emotional distress. Understanding its prevalence and impact on population health is crucial, as it can lead to increased healthcare utilization for management options. Quality measures may include patient-reported outcomes and satisfaction with treatment, highlighting the importance of effective management strategies in this patient population.

ICD-9 vs ICD-10

Focal hyperhidrosis can significantly affect a patient's quality of life, leading to social anxiety, decreased productivity, and emotional distress. Understanding its prevalence and impact on population health is crucial, as it can lead to increased healthcare utilization for management options. Quality measures may include patient-reported outcomes and satisfaction with treatment, highlighting the importance of effective management strategies in this patient population.

Reimbursement & Billing Impact

Reimbursement considerations include the use of botulinum toxin injections, which may be covered by insurance if deemed medically necessary. Common denials may arise from lack of documentation supporting the diagnosis or treatment efficacy. Best practices include ensuring that all documentation is thorough and clearly outlines the patient's condition and the rationale for treatment.

Resources

Clinical References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Coding & Billing References

  • •
    ICD-10 Official Guidelines for L00-L99
  • •
    Clinical Documentation Requirements

Frequently Asked Questions

What specific conditions are covered by L74.5?

L74.5 specifically covers focal hyperhidrosis, which includes excessive sweating localized to areas such as the palms, soles, axillae, and face. It does not cover generalized hyperhidrosis or secondary hyperhidrosis due to underlying medical conditions.

When should L74.5 be used instead of related codes?

L74.5 should be used when the sweating is localized and not due to a systemic condition. If the hyperhidrosis is generalized or secondary to another medical issue, other codes should be considered.

What documentation supports L74.5?

Documentation should include a detailed patient history, physical examination findings, and any diagnostic tests performed, such as QSART. Treatment plans and responses to therapy should also be documented to support the diagnosis.