Hypopituitarism is a rare disorder of decreased pituitary hormone secretion wherein the pituitary gland fails to produce normal amounts of one or more hormones. The pituitary gland is a small bean-shaped gland situated on the underside of your brain (behind your nose and between your ears) which secretes hormones that influence nearly every part of your bodily functions. The gland produces eight types of hormones – each of which can affect your body’s routine functions related to growth, controlling metabolism, blood pressure and reproduction. The condition can develop very slowly, over several months or even over several years. Treatment for this condition basically involves hormone correction. Taking the right hormone medications can help effectively control the prominent symptoms associated with the condition. Physicians treating hypopituitarism have to ensure accurate documentation of the patient’s condition and treatment provided. Endocrinology medical billing and coding has become increasingly complex due to the growing number of rules and regulations. Outsourcing medical billing and coding services could help endocrinologists and other physicians ensure accurate and timely claim filing for appropriate reimbursement.
Hypopituitarism occurs when your pituitary gland does not release enough of one or more of any of these hormones such as adrenocorticotropic hormone (ACTH), thyroid-stimulating hormone (TSH), antidiuretic hormone (ADH), Prolactin, follicle-stimulating hormone (FSH), growth hormone (GH), luteinizing hormone (LH) and Oxytocin. The hormone condition may be the result of inherited disorders, but more often it’s acquired. Tumor of the pituitary gland is one of the common causes associated with the condition. A tumor can compress the optic nerves, causing visual disturbances. Other potential causes include – head injuries, autoimmune inflammation (hypophysitis), stroke, infections of the brain (such as meningitis), sarcoidosis, blood loss during childbirth and radiation treatments. However, in some cases, the exact cause of hypopituitarism may be unknown.
Unlock the Signs and Symptoms
Hypopituitarism is often a progressive condition. The signs and symptoms in most cases develop gradually and may at times be subtle and remain unnoticed for months or even years. The signs and symptoms of this hormonal disorder may vary from one person to another and may depend on which pituitary hormones are deficient and how severe the deficiency is. Common symptoms include –
- Weight loss or weight gain
- Sensitivity to cold or difficulty staying warm
- Fatigue and/or weakness
- Excessive thirst and urination
- Decreased sex drive
- Decreased appetite
- Stiffness in the joints
- Short stature in children
- Infertility
- Hot flashes, irregular or no periods, loss of pubic hair, and inability to produce milk for breast-feeding in women
- Headache and dizziness
- Facial puffiness
- Decreased facial or body hair in men
- Anemia
Diagnosing and Treating an Underactive Pituitary Gland
If your physician feels that you have hypopituitarism, he/she will conduct several tests to check the levels of various hormones in your body. Several tests that may be conducted include –
- Blood tests – to detect deficits in hormones as a result of pituitary failure
- Stimulation or dynamic testing – to check your body’s secretion of hormones after consuming certain medications that stimulate hormone production
- Vision tests – to check whether the growth of a pituitary tumor has impaired your sight or visual fields
Once the hormone levels in your body are correctly determined, physicians will check the other parts of your body (target organs) which those hormones normally affect. In some cases, the problem may not be with your pituitary gland, but rather with the target organs. In addition, physicians will also conduct several diagnostic imaging tests such as CT scan or MRI scan to check if a tumor on your pituitary gland is affecting its normal function.
Treatment for this condition may be lifelong. As this condition may generally affect a number of hormones, there is no single course of treatment for this condition. One of the initial treatment modalities will be related to hormones – to bring the hormone levels back to normal. In fact, these hormone dosages are given to match the amounts that the body would normally produce if it didn’t have a pituitary gland problem. Hormone replacement medications may include – Corticosteroids, Levothyroxine (Levoxyl, Synthroid, others), sex hormones (testosterone in men and estrogen or a combination of estrogen and progesterone in women) and growth hormones (also called somatropin). In some cases, if a tumor is causing pituitary problems, surgery to remove the tumor growth may be done in order to restore your hormone production to normal. On the other hand, physicians will recommend radiation therapy as well.
Endocrinologists and other physicians who diagnose, screen and provide treatment procedures for hypopituitarism must carefully document the same using the correct medical codes. Medical billing and coding services provided by reputable medical billing companies can help physicians use the correct codes for their medical billing purposes.
ICD-10 codes for Hypopituitarism
E22 – Hyper function of pituitary gland
- E22.0 – Acromegaly and pituitary gigantism
- E22.1 – Hyperprolactinemia
- E22.2 – Syndrome of inappropriate secretion of antidiuretic hormone
- E22.8 – Other hyperfunction of pituitary gland
- E22.9 – Hyperfunction of pituitary gland, unspecified
E23 – Hypo function and other disorders of the pituitary gland
- E23.0 – Hypopituitarism
- E23.1 – Drug-induced hypopituitarism
- E23.2 – Diabetes insipidus
- E23.3 – Hypothalamic dysfunction, not elsewhere classified
- E23.6 – Other disorders of pituitary gland
- E23.7 – Disorder of pituitary gland, unspecified
If the pituitary gland is permanently damaged, proper hormone replacement generally requires life-long treatment. The initial course of hormone replacement therapy may take time to determine the patient’s response and to find the best dose. The endocrinologist will correctly monitor the levels of hormones in your blood to ensure that the patient is getting adequate, but not excessive amount of hormones. Physicians will adjust the dosage of corticosteroids if the patient becomes seriously ill or experiences major physical stress.
In short, patients can expect a normal life span, as long as they regularly consume the correct dose of medications recommended by endocrinologists or other physicians.
Endocrinology medical coding can be complex, as there are several codes associated with the condition. By outsourcing these tasks to a reliable and established medical billing and coding company – that offers the services of AAPC-certified coding specialists, healthcare practices can ensure correct and timely medical billing and claims submission.
Rajeev Rajagopal, the President of OSI, has a wealth of experience as a healthcare business consultant in the United States. He has a keen understanding of current medical billing and coding standards.