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ICD-9-CM Codes

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  • 252.0 Hyperparathyroidism

  • 252.00 Hyperparathyroidism, unspecified

  • 252.01 Primary hyperparathyroidism

  • 252.08 Other hyperparathyroidism

  • 252.02 Secondary hyperparathyroidism, non-renal

  • 588.81 Secondary hyperparathyroidism (of renal origin)

  • Associated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint, pelvic region, and thigh

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy not elsewhere classified

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM Codes

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  • Index Line 39663 Hyperperistalsis

  • Index Line 39781 Hyperproteinemia

  • Index Line 52101 Myopathy > in (due to) > hyperparathyroidism NEC

  • Index Line 39656 Hyperparathyroidism

  • Index Line 39657 Hyperparathyroidism > primary

  • Index Line 39658 Hyperparathyroidism > secondary (renal)

  • Index Line 39660 Hyperparathyroidism > specified NEC

  • Index Line 39661 Hyperparathyroidism > tertiary

  • E21 Hyperparathyroidism and other disorders of parathyroid gland

  • E21.0 Primary hyperparathyroidism

  • E21.1 Secondary hyperparathyroidism, not elsewhere classified

  • E21.2 Other hyperparathyroidism

  • E21.3 Hyperparathyroidism, unspecified

  • N25.81 Secondary hyperparathyroidism of renal origin

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Preferred Practice Patterns1

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Key Features

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Description

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  • Excess of systemic hyperparathyroid hormone (PTH) (hypersecretion) from one or more of the four parathyroid glands

    • Hormone regulates calcium in the bloodstream, producing hypercalcemia and hyperphospatemia

  • May be primary or secondary to another disease process

  • Primary hyperparathyroidism (HPT) (most common)

    • Enlargement of one of the glands

    • Excess production of the hormone

    • Increased calcium in the blood/hypercalcemia

  • Secondary hyperthyroidism

    • Secondary disease causing low levels of calcium in the body

    • Chromic renal insufficiency

    • Calcium malabsorption

    • Osteomalacia

  • Tertiary hyperparathyroidism

    • Glandular hyperfunction and hypersecretion even after correction of abnormality

    • Caused by chronic renal failure

  • Quartary hyperthyroidism

    • After surgical removal of primary hyperparathyroidism

  • Familial hypocalciuric hypercalcemia (FHH)

    • Autosomal inheritance

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Essentials of Diagnosis

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  • Usually diagnosed before symptoms occur via complete blood count (CBC) test

  • Elevated calcium in the blood

  • Elevated parathyroid hormone

  • Decreased phosphorus in the blood

  • Vitamin D deficiency

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General Considerations

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  • May cause pathology in multiple organ systems

    • Gastrointestinal (GI): liver

    • Cardiovascular: heart, peripheral circulation, blood pressure

    • Integument

  • Decreased calcium in the bones

  • May result in secondary problems such as aerobic capacity and muscle endurance impairment, sarcopenia, weakness/impaired muscle performance, musculoskeletal problems, neuromuscular problems, indicating the need for physical therapy intervention depending on severity

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Demographics

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  • Primary type in adults: 1:1,000 in the Unites States2

  • More common in individuals with Columbia descent

  • More common over age 50

  • More common in females after menopause2

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Clinical Findings

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Signs ...

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