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Secondary hyperparathyroidism of renal origin

ICD10CM code

Name of the Condition

  • Secondary Hyperparathyroidism of Renal Origin

Summary

Secondary hyperparathyroidism of renal origin is a condition where the parathyroid glands secrete excessive amounts of parathyroid hormone (PTH) due to chronic kidney disease. This overproduction of PTH occurs because the kidneys cannot effectively balance calcium and phosphorus levels in the body.

Causes

The condition is primarily caused by chronic kidney disease (CKD). As kidney function deteriorates, phosphate excretion is impaired, leading to phosphate retention, decreased calcium levels, and consequently, increased PTH production.

Risk Factors

  • Chronic kidney disease or kidney failure
  • Long-term dialysis
  • Older age
  • Poor dietary management in kidney patients
  • Family history of kidney diseases

Symptoms

  • Bone pain or fractures
  • Muscle weakness
  • Joint pain
  • Fatigue
  • Itching
  • Soft tissue calcifications

Diagnosis

  • Blood tests to measure levels of calcium, phosphate, and parathyroid hormone
  • Bone density tests
  • X-rays or other imaging to examine bone structures

Treatment Options

  • Phosphate binders to reduce phosphate levels
  • Vitamin D supplements to manage calcium levels
  • Calcimimetics to reduce PTH production
  • Dialysis optimization
  • In severe cases, surgical removal of part of the parathyroid glands (parathyroidectomy)

Prognosis and Follow-Up

Effective management can lead to improved symptoms and reduced risk of bone and cardiovascular complications. Regular follow-up is essential to monitor blood levels of calcium, phosphate, and PTH to adjust treatments as necessary.

Complications

  • Bone deformities or fractures
  • Cardiovascular disease
  • Severe itching
  • Vascular and soft tissue calcifications

Lifestyle & Prevention

  • Following dietary guidelines to manage phosphate intake, like avoiding high-phosphorus foods
  • Regular exercise as advised by a healthcare provider
  • Adhering to prescribed medications and treatments

When to Seek Professional Help

  • Experiencing severe or sudden pain in bones or muscles
  • New or worsening symptoms, such as increased fatigue or itching
  • Signs of severe complications like cardiovascular symptoms

Additional Resources

  • National Kidney Foundation (www.kidney.org)
  • American Association of Kidney Patients (www.aakp.org)

Tips for Medical Coders

  • Ensure that chronic kidney disease is coded alongside secondary hyperparathyroidism to fully capture the patient's condition.
  • Use ICD-10 code N25.81 specifically for secondary hyperparathyroidism of renal origin.
  • Be aware that documentation should clearly indicate the renal origin to justify the use of this specific code.

Medical Policies and Guidelines for Secondary hyperparathyroidism of renal origin

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