Dermatology Coding Alert

Question: What is the appropriate diagnosis code for hyperhidrosis?

Wisconsin Subscriber

Answer: Begin by checking 705.21 (Primary focal hyperhidrosis) and 705.22 (Secondary focal hyperhidrosis). ICD-9’s “Symptoms, Signs and Ill-defined Conditions” section also includes 780.8 (Generalized hyperhidrosis).

ICD-10: Beginning Oct. 1, 2015, use one of these ICD-10 codes to describe 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.

A variety of underlying conditions can cause secondary hyperhidrosis, including medication side effects and some rare dermatologic syndromes. Researchers are also studying the connection between hyperhidrosis and social anxiety disorders and other psychiatric conditions. Get more details about the patient’s condition from your physician before assigning a diagnosis.

For the chemodenervation procedure – injection of Botox into the sweat glands – to treat hyperhidrosis, turn to one of these CPT® codes:

• 64650 – Chemodenervation of eccrine glands; both axillae

• 64653 – Chemodenervation of eccrine glands; other area(s) (e.g., scalp, face, neck), per day

• 64999 – Unlisted procedure, nervous system (for hands and feet, as mentioned in an instruction in CPT®).