Primary Care Coding Alert

Question: Our provider diagnosed a male patient with estrogen excess and used E28.0 for the diagnosis. I don’t think this is the correct code for a male patient, but I can’t locate a better one. What would be the best diagnosis code to use in this instance?

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Answer: We normally think of estrogen as the female hormone, but men, too, produce it. When men produce too much estrogen, it can lead to problems related to sexual functions, including infertility and erectile dysfunction, as well other issues, such as enlarged breasts.

While E28.0 (Estrogen excess) is the correct code for estrogen excess, you would not use it for a male patient. That’s because the E28 codes are used specifically for conditions related to ovarian disorders, and so can only be used for female patients.

Locating the exact code for male estrogen excess is not so easy, however, partly because your provider has to pinpoint the cause of the condition. Possible candidates include E29.1 (Testicular hypofunction) or a code from the T38.5- (Poisoning by, adverse effect of and underdosing of other estrogens and progestogens) group if the patient is taking supplemental testosterone.

You may also have to use an unspecified code, such as E34.9 (Endocrine disorder, unspecified), or a signs and symptoms code, such as R86.1 (Abnormal level of hormones in specimens from male genital organs) or R89.1 (Abnormal level of hormones in specimens from other organs, systems and tissues) depending on your provider’s preference.