N25.81

Billable

Secondary hyperparathyroidism of renal origin

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

Overactive parathyroid glands that develop as a result of kidney disease and impaired calcium regulation.

Coding Tips

•This is a secondary condition caused by renal dysfunction; code the underlying kidney disease first
•Verify if parathyroid surgery was performed, which may affect coding

Clinical Significance

Secondary hyperparathyroidism of renal origin represents overactive parathyroid glands due to chronic kidney disease and disrupted calcium-phosphorus metabolism. This condition indicates CKD-mineral bone disorder requiring specialized management to prevent bone disease and cardiovascular complications associated with elevated PTH levels.

Documentation Requirements

✓Secondary hyperparathyroidism clearly documented
✓Renal origin specifically identified and documented
✓Elevated parathyroid hormone (PTH) levels documented
✓Underlying chronic kidney disease documented and coded
✓Abnormal calcium, phosphorus, or vitamin D levels
✓Treatment plan for hyperparathyroidism and underlying CKD
✓Monitoring schedule for PTH, calcium, and phosphorus levels

Excludes 1 — Do NOT code together

secondary hyperparathyroidism, non-renal (E21.1)

Excludes 2 — Not included here, may code separately

metabolic disorders classifiable to E70-E88

Commonly Confused Codes

E21.1 — Secondary hyperparathyroidism, not elsewhere classified (not specifically renal)E21.0 — Primary hyperparathyroidism (primary parathyroid disease)N25.0 — Renal osteodystrophy (bone disease, not specifically PTH excess)E83.30 — Disorder of phosphorus metabolism, unspecified (metabolic, not PTH)

Code Hierarchy

└N25Disorders resulting from impaired renal tubular function └N25.8Other disorders resulting from impaired renal tubular function └N25.81Secondary hyperparathyroidism of renal origin

└N25.81Secondary hyperparathyroidism of renal origin