ICD Code E21.1

ICD code E21.1 is secondary hyperparathyroidism, not elsewhere classified, which refers to an overactivity of the parathyroid glands caused by another underlying condition, such as chronic kidney disease, rather than a problem originating in the parathyroid glands themselves.

1. Presence of elevated parathyroid hormone (PTH) levels

2. Evidence of underlying chronic condition affecting calcium or phosphate metabolism (e.g., chronic kidney disease, malabsorption syndromes)

3. Laboratory findings of abnormal serum calcium and/or phosphate levels (often hypocalcemia and/or hyperphosphatemia)

4. Absence of primary parathyroid gland pathology (e.g., no parathyroid adenoma or carcinoma)

5. Clinical symptoms or signs consistent with disturbances in calcium/phosphate balance (e.g., bone pain, muscle weakness, pruritus)

6. Exclusion of other specified causes of secondary hyperparathyroidism

Relevant CPT codes that may be used to treat ICD code E21.1 include:

- 82310 (Calcium; total)

- 82306 (Vitamin D; 25 hydroxy, includes fraction(s), if performed)

- 83970 (Parathyroid hormone [PTH])

- 36415 (Collection of venous blood by venipuncture)

- 60500 (Parathyroidectomy or exploration of parathyroid(s))

- 60502 (Parathyroidectomy or exploration of parathyroid(s); re-exploration)

- 99201–99499 (Evaluation and management services, as appropriate)

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