Know the Medical Codes for Reporting Hyperhidrosis

Know the Medical Codes for Reporting Hyperhidrosis The blog discusses hyperhidrosis – an excessive sweating disorder that is not normally related to heat or physical exercise.

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Hyperhidrosis is a disorder that involves excessive sweating that is not normally related to heat or physical exercise. The sweating can occur in unusual situations like in cooler weather or without any trigger at all. In fact, sweating becomes so excessive that it soaks through the clothes or drips off the hands. Also known as polyhidrosis or sudorrhea, the condition can affect just one area or the whole body. However, as people don’t usually realize that this is a medical condition, they don’t seek any treatment for it. Treatment modalities involve medications and therapies (in mild cases) and surgery to remove the sweat glands (in severe cases). For correct clinical documentation of this sweat disorder, dermatologists can depend on the services of a reliable medical billing and coding company.

Types, Causes and Symptoms There are two different types of hyperhidrosis - primary idiopathic hyperhidrosis and secondary hyperhidrosis. The underlying causes associated with the condition depend on the specific type of hyperhidrosis the person has. Secondary hyperhidrosis is caused by certain medical conditions like menopause or hyperthyroidism and most commonly affects the feet, face and armpits. Hyperhidrosis may be present from birth or may develop at a later stage in life. However, most cases of excessive sweating tends to start during a person’s teenage years.

Excessive sweating that disrupts normal activities is one of the common symptoms associated with the condition. Other related signs and symptoms include – sweat that occurs on both sides of your body in roughly the same amount, noticeable sweating that soaks through clothing, clammy or wet palms of the hands/wet soles of the feet and irritating and painful skin problems (like fungal or bacterial infections).

Hyperhidrosis Diagnosis and Treatment Diagnosis begins with a detailed patient evaluation wherein physicians will ask questions about the patterns of sweating – including the effected body parts and frequency of sweating episodes. Dermatologists may recommend blood and urine tests to check whether the condition is caused due to any other underlying conditions. Other tests like – iodine-starch test, skin conductance and a thermoregulatory sweat test may also be performed. Common treatment options include medications like – specialized antiperspirant, Iontophoresis, Anticholinergic drugs, Nerve-blocking medications, Antidepressants and Botox (botulinum toxin) injections.

In severe cases, surgery may be an option. Surgical options include – sweat gland removal, microwave therapy (delivering microwave energy to destroy sweat glands) and endoscopic thoracic sympathectomy (severing the nerves that carry messages to the sweat glands).

Medical Codes for Reporting Hyperhidrosis Medical codes for coding hyperhidrosis include –

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ICD-10 Codes • • ✓ ✓ ✓ ✓ ✓ • •

L74.5 – Focal hyperhidrosis L74.51 – Primary focal hyperhidrosis L74.510 – Primary focal hyperhidrosis, axilla L74.511 – Primary focal hyperhidrosis, face L74.512 – Primary focal hyperhidrosis, palms L74.513 – Primary focal hyperhidrosis, soles L74.519 – Primary focal hyperhidrosis, unspecified L74.52 – Secondary focal hyperhidrosis R61 – Generalized hyperhidrosis

CPT Codes • 15876-15879 – Suction assisted lipectomy [includes codes 15876, 15877, 15878, 15879] • 17999 – Unlisted procedure, skin, mucous membrane and subcutaneous tissue [when specified as laser or microwave destruction or resection of subcutaneous sweat glands] • 32664 – Thoracoscopy, surgical; with thoracic sympathectomy • 64520 -Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) • 64650 – Chemodenervation of eccrine glands; both axillae • 64653 – Other area(s) (e.g., scalp, face, neck), per day • 64802 – 64823 – Excision sympathetic nerves • 64999 – Unlisted procedure, nervous system [when specified as endoscopic lumbar sympathectomy] • 97033 – Application of a modality to one or more areas; iontophoresis, each 15 minutes HCPCS Codes • E1399 – Durable medical equipment, miscellaneous [when specified as iontophoresis device for home use] • J0585 -Botulinum toxin type A, per unit • J0587 – Botulinum toxin type B, per 100 units Dermatology medical billing and coding can be challenging. For correct and timely billing and claims submission, dermatology practices can rely on medical coding services provided by a company with experienced AAPC-certified coding specialists.

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