Podiatry Coding & Billing 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).

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 to treat hyperhidrosis in the feet, you must turn to unlisted-procedure code 64999 (Unlisted procedure, nervous system). Even though 64653 (Chemodenervation of eccrine glands; other area[s] [e.g., scalp, face, neck], per day) -- with its description of "other areas" -- might seem to open up the possibility for use when injecting the sympathetic nerves of the feet, you can't ignore the new parenthetical note that specifically points coders to 64999 for "chemodenervation of extremities (e.g., hands or feet)."