E22.1

Billable

Hyperprolactinemia

HCC Category Mapping

V24HCC 23 — Other Significant Endocrine and Metabolic Disorders

0.230

ESRDHCC 23 — Other Significant Endocrine and Metabolic Disorders

0.000

RxHCCHCC 43 — Other Significant Endocrine and Metabolic Disorders

0.000

What This Code Means

A condition where the pituitary gland produces too much prolactin hormone, leading to elevated prolactin levels in the blood and potential symptoms like galactorrhea or reproductive dysfunction.

Coding Tips

•Document whether hyperprolactinemia is due to a prolactinoma (pituitary adenoma) or other causes, as this may affect treatment decisions
•Note any associated symptoms such as amenorrhea, infertility, or galactorrhea for complete clinical documentation

Clinical Significance

Hyperprolactinemia involves excessive prolactin secretion, most commonly from a pituitary prolactinoma, causing galactorrhea, menstrual irregularities, infertility, and decreased bone density. In men, it may present with hypogonadism, erectile dysfunction, and gynecomastia, making it frequently underdiagnosed.

Documentation Requirements

✓Document the underlying cause (prolactinoma, medication-induced, hypothyroidism), prolactin level with reference range, tumor size if applicable (microprolactinoma vs macroprolactinoma), reproductive symptoms, and treatment approach (dopamine agonists, surgery).

Use Additional Code

code for adverse effect, if applicable, to identify drug (T36-T50 with fifth or sixth character 5)

Commonly Confused Codes

E22.0 (acromegaly from growth hormone excess, not prolactin), E22.8 (other pituitary hyperfunction for non-prolactin hormones), D35.2 (benign pituitary neoplasm which should be coded separately if prolactinoma is present).

Code Hierarchy

└E22Hyperfunction of pituitary gland └E22.1Hyperprolactinemia

└E22.1Hyperprolactinemia