# icd9



## mamacase1 (Oct 1, 2010)

can some one tell me what icd9 code you would use for liddle's syndrome?


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## diane1217 (Oct 1, 2010)

I think this is too rare of a disorder to have an ICD-9 code, can you just code the symptoms?


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## eadun2000 (Oct 1, 2010)

it codes to hyperaldosteronism


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## mitchellde (Oct 1, 2010)

It is actually pseudoaldosteronism, so I would suggest 276.4


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## eadun2000 (Oct 1, 2010)

per Encoder it codes to hyperaldosteronism.  When you put in Liddle's Syndrome it says Liddle's Syndrome (pseudohyperaldosteronism).  When you click on it, the next screen says 1. hyperaldosteronism unspecified 2. glucocorticoid remediable aldersteronism 3. conn's syndrome 4. bartter's syndrome 5. other secondary aldosteronism.  Without any additional information, you have to click on the 1. hyperaldosteronism unspecified.  The next screen says 1. specified as causing hypertension 2. with co-existing hypertension 3. no mention of hypertension or already coded.  Have no choice but to go with 3. no mention of hypertension or already coded as I do not know if the pt has hypertension or not.  The next screen says the code is 255.10 hyperaldosteronism unspecified.  Obviously if there is hypertension or other information in the chart that I do not know, then it can affect the final code.  However, without that information, this is what the code comes out to be.  Personally I very rarely use Encoder as the tell all.  However, when something is not specifically specified in the book, I tend to lean towards the Encoder for help, especially when doing research for the Liddle's Syndrome does state either pseudohyperaldosteronism or hyperaldosteronism.  Anyways, regardless, the code I come up with is 255.10.  Wish the book had every single syndrome/disease known to man listed in black and white, but unfortunately it does not.  Hope this helps.


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## mitchellde (Oct 1, 2010)

I usually use the Merck Manual to look up medical information, it states:
Liddle syndrome is a rare hereditary disorder in which the kidneys excrete K but retain too much Na and water, leading to hypertension. Symptoms are of hypertension, fluid retention, and metabolic alkalosis. Diagnosis is through measurement of urinary electrolytes. K-sparing diuretics provide the best treatment.

Liddle syndrome is a rare autosomal dominant disorder of renal epithelial transport that clinically resembles primary aldosteronism (see Adrenal Disorders: Primary Aldosteronism), with hypertension and hypokalemic metabolic alkalosis but without elevated plasma renin or aldosterone levels. The syndrome results from an inherently increased activity of the luminal membrane Na channels, which accelerates Na resorption and K secretion in the collecting tubule.

Patients with Liddle syndrome present at < 35 yr. Hypertension and signs and symptoms of hypokalemia (see Fluid and Electrolyte Metabolism: Hypokalemia) and metabolic alkalosis occur.

Diagnosis

    *
      Urine Na level
    *
      Plasma renin and aldosterone levels

Diagnosis is suggested by the presence of hypertension in a young patient, particularly one with a positive family history. Low urine Na (< 20 mEq), normal plasma renin and aldosterone levels, and response to empiric treatment usually are considered sufficient to confirm the diagnosis. Definitive diagnosis can be achieved through genetic testing (see www.genetests.org for more information).
My suggestion is to discuss this with your physician as you do need to get the right diagnosis code and you need his/her assistance on this to determine the correct synonym for Liddle syndrome.


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