In this blog series, we’ve been highlighting relatively unknown risk adjusted conditions or ones that bring some confusion; so far, we’ve looked at a few pulmonary disorders, most recently, bronchiectasis. Today, we’ll consider the adrenal nodule, coded E27.9. Found above each kidney, the adrenal gland makes several types of hormones that regulate metabolism and even control our body’s response to stress.
The Journal of Endocrinology & Metabolism, in fact, refers to the adrenal mass – found in an imaging study performed for reasons unrelated to adrenal disease and often accompanied by obesity, diabetes, or hypertension – as an adrenal incidentaloma. Their prevalence increases with age and they are found quite incidentally given the increase in imaging studies performed. The majority of adrenal nodules are non-cancerous and pose no great threat because they do not produce an overabundance of hormones. However, the general treatment is one of observation and monitoring of the nodule size and hormone levels.
Adrenal nodules or masses are not to be confused with the adrenal adenoma, a benign neoplasm of the adrenal gland, coded as D35.0-. Adenomas are non-risk adjusted codes. Remember that it would be improper coding to call an adenoma a “mass” and thereby, report a risk adjusted diagnosis code. When coding to the highest level of specificity, we select the most appropriate code to the condition.