Based in U.S., Outsource Strategies International (OSI) has years of experience in providing medical billing and coding services for diverse medical specialties. Our clients include individual physicians, medical practices, clinics and hospitals.

In today’s podcast, Meghann Drella, one of our Senior Solutions Managers, discusses medical codes to report hyperhidrosis.

Hello and welcome to our podcast series. My name is Meghann Drella and I'm a Senior Solutions Manager here at Outsource Strategies International (OSI). Today, I'll be discussing medical codes for reporting hyperhidrosis, an excessive sweating disorder.

00:16 What is Hyperhidrosis?

Hyperhidrosis is characterized by excessive sweating that is not normally related to heat or other physical exercises. Also known as polyhidrosis or sudorrhea, the condition can affect just one specific area or the whole body. It can be localized to a particular anatomical area or may be diffuse. People, as part of the condition, sweat so much that it soaks through the clothes or drips off the hands. The sweating can occur in unusual situations like in cooler weather or without any trigger at all. It can also be caused by other medical conditions like menopause or hyperthyroidism. Most commonly affecting 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 tend to start during a person’s teenage years. It is estimated that about 4.8 percent of Americans have hyperhidrosis, but this figure may be underreported. Besides disrupting normal daily activities, excessive sweating can cause social anxiety and embarrassment. In most cases, people don’t seek proper treatment as they don’t really realize that they suffer from a treatable medical condition. Treatment modalities for this condition generally begin with prescription-strength antiperspirants followed by other medications and therapies. In severe cases, physicians may advise surgery either to remove the sweat glands or to disconnect the nerves responsible for the overproduction of sweat.

Sweating is the body’s natural mechanism to cool itself. The nervous system automatically triggers the sweat glands when the body temperature increases. In addition, sweating also occurs due to certain other conditions, such as warm weather, physical activity, nervousness, stress, and feelings of fear or anger. The underlying causes associated with the condition depend on the specific type of hyperhidrosis.

02:01 Types of Hyperhidrosis

There are two types of hyperhidrosis which may either occur due to an underlying health condition, or have no apparent causes at all.

Primary Idiopathic Hyperhidrosis – This condition usually starts in childhood. With this type, the nerves responsible for signaling your sweat glands become overactive, even when they do not get triggered by physical activity or a rise in temperature. There is no medical cause for this type and in most cases are localized and have a hereditary component, with 30 to 50 percent of people with this type having a family history of excessive sweating. The condition usually affects the palms and soles and in some cases the face.

Secondary Hyperhidrosis – A less common type, the person with this condition sweats too much because of an underlying health condition, such as obesity, gout, menopause, a tumor, thyroid problems, diabetes mellitus, hyperthyroidism, nervous system disorders, heart attack and infections. In some cases, use of certain medications can also cause heavy sweating. With this type, a person may sweat all over the body, or just in one area. In fact, a person may also sweat while he/she is sleeping.

03:07 Signs and Symptoms

Excessive sweating that disrupts normal activities is one of the common symptoms associated with this condition. The sweating experienced by people with hyperhidrosis far exceeds the normal sweating and becomes embarrassing, causing severe discomfort and anxiety. In fact, episodes of excessive sweating occur at least once in a week for no clear reason. Other related signs and symptoms include –

  • Sweat that occurs on both sides of your body in roughly the same amount
  • Worrying about having stained clothing
  • Socially withdrawn (causing depression)
  • Noticeable sweating that soaks through clothing
  • Irritating and painful skin problems
  • Clammy or wet soles of the feet and
  • Clammy or wet palms of the hands

Even though excessive sweating is a serious symptom associated with the condition, it can also be a symptom of other serious conditions. In such cases, patients need to consult a physician if they experience symptoms like – sweating and weight loss, prolonged and unexplained sweating, sweating  and sweating accompanied by fever, chest pain, shortness of breath, and rapid heartbeat.

04:07 Diagnosis and Treatment

Diagnosis of the condition begins with a detailed patient evaluation by the physician wherein they will ask questions about the patterns of sweating – which parts of the body are affected, how often sweating episodes occur, and whether sweating occurs during sleep. Dermatologists may recommend conducting blood and urine tests to check whether the condition is caused due to any other underlying conditions, such as an overactive thyroid or low blood sugar. They may recommend other tests like – iodine-starch test, skin conductance and a thermoregulatory sweat test.

As hyperhidrosis is a treatable condition, developing a clear treatment plan can help manage the symptoms in a better manner. Treatments for the condition may depend on the underlying condition causing sweating. If the sweating is a side effect of a medication, it is important to talk to your dermatologist as he can help switch medications or lower the dosage. In addition, making alterations in daily activity and lifestyle like using antiperspirants and armpit shields, using loose clothing, choosing shoes and socks made of natural materials, regular bathing and airing the feet may help improve the intensity of the symptoms. Dermatology medical billing and coding can be challenging.

I hope this helps, but always remember that documentation as well as a thorough knowledge of payer regulations and guidelines is critical to ensure accurate reimbursement for the procedures performed.

Thank you so much for joining me and stay tuned for my next podcast.