Chapter IV

Endocrine, nutritional and metabolic diseases

Disorders of other endocrine glands

Excludes: galactorrhoea ( N64.3 )
gynaecomastia ( N62 )

E20 Hypoparathyroidism
Excludes: Di George's syndrome ( D82.1 )
postprocedural hypoparathyroidism ( E89.2 )
tetany NOS ( R29.0 )
transitory neonatal hypoparathyroidism ( P71.4 )
E20.0 Idiopathic hypoparathyroidism
E20.1 Pseudohypoparathyroidism
E20.8 Other hypoparathyroidism
E20.9 Hypoparathyroidism, unspecified
Parathyroid tetany

E21 Hyperparathyroidism and other disorders of parathyroid gland
Excludes: osteomalacia:
· adult ( M83.- )
· infantile and juvenile ( E55.0 )
E21.0 Primary hyperparathyroidism
Hyperplasia of parathyroid
Osteitis fibrosa cystica generalisata [von Recklinghausen's disease of bone]
E21.1 Secondary hyperparathyroidism, not elsewhere classified
Excludes: secondary hyperparathyroidism of renal origin ( N25.8 )
E21.2 Other hyperparathyroidism
Excludes: familial hypocalciuric hypercalcaemia ( E83.5 )
E21.3 Hyperparathyroidism, unspecified
E21.4 Other specified disorders of parathyroid gland
E21.5 Disorder of parathyroid gland, unspecified

E22 Hyperfunction of pituitary gland
Excludes: Cushing's syndrome ( E24.- )
Nelson's syndrome ( E24.1 )
overproduction of:
· ACTH not associated with Cushing's disease ( E27.0 )
· pituitary ACTH ( E24.0 )
· thyroid-stimulating hormone ( E05.8 )
E22.0 Acromegaly and pituitary gigantism
Arthropathy associated with acromegaly+ ( M14.5* )
Overproduction of growth hormone
Excludes: constitutional:
· gigantism ( E34.4 )
· tall stature ( E34.4 )
increased secretion from endocrine pancreas of growth hormone-releasing hormone ( E16.8 )
E22.1 Hyperprolactinaemia
Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.
E22.2 Syndrome of inappropriate secretion of antidiuretic hormone
E22.8 Other hyperfunction of pituitary gland
E22.9 Hyperfunction of pituitary gland, unspecified

E23 Hypofunction and other disorders of pituitary gland
Includes: the listed conditions whether the disorder is in the pituitary or the hypothalamus
Excludes: postprocedural hypopituitarism ( E89.3 )
E23.0 Hypopituitarism


Fertile eunuch syndrome
Hypogonadotropic hypogonadism
Idiopathic growth hormone deficiency
Isolated deficiency of:
·  ACTH (adrenocorticotrophic hormone)
   · gonadotropin
   · growth hormone
   · pituitary hormone
·  TSH (thyroid stimulatinghormone)
Kallmann's syndrome
Lorain-Levi short stature
Necrosis of pituitary gland (postpartum)
· cachexia
· insufficiency NOS
· short stature
Sheehan's syndrome
Simmonds' disease
E23.1 Drug-induced hypopituitarism
Use additional external cause code (Chapter XX), if desired, to identify drug.
E23.2 Diabetes insipidus
Excludes: nephrogenic diabetes insipidus ( N25.1 )
E23.3 Hypothalamic dysfunction, not elsewhere classified
Excludes: Prader-Willi syndrome ( Q87.1 )
Russell-Silver syndrome ( Q87.1 )
E23.6 Other disorders of pituitary gland
Abscess of pituitary
Adiposogenital dystrophy
E23.7 Disorder of pituitary gland, unspecified

E24 Cushing's syndrome
E24.0 Pituitary-dependent Cushing's disease
Overproduction of pituitary ACTH
Pituitary-dependent hyperadrenocorticism
E24.1 Nelson's syndrome
E24.2 Drug-induced Cushing's syndrome
Use additional external cause code (Chapter XX), if desired, to identify drug.
E24.3 Ectopic ACTH syndrome
E24.4 Alcohol-induced pseudo-Cushing's syndrome
E24.8 Other Cushing's syndrome
E24.9 Cushing's syndrome, unspecified

E25 Adrenogenital disorders
Includes: adrenogenital syndromes, virilizing or feminizing, whether acquired or due to adrenal hyperplasia consequent on inborn enzyme defects in hormone synthesis
· adrenal pseudohermaphroditism
· heterosexual precocious pseudopuberty
· isosexual precocious pseudopuberty
· macrogenitosomia praecox
· sexual precocity with adrenal hyperplasia
virilization (female)
E25.0 Congenital adrenogenital disorders associated with enzyme deficiency

Congenital adrenal hyperplasia

17 alpha-hydroxylase deficiency
3 beta-hydroxysteroid dehydrogenase deficiency
11 beta-hydroxylase deficiency
17, 20 lyase deficiency
21-Hydroxylase deficiency
Salt-losing congenital adrenal hyperplasia
E25.8 Other adrenogenital disorders
Idiopathic adrenogenital disorder
Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.
E25.9 Adrenogenital disorder, unspecified
Adrenogenital syndrome NOS

E26 Hyperaldosteronism
E26.0 Primary hyperaldosteronism
Conn's syndrome
Primary aldosteronism due to adrenal hyperplasia (bilateral)
E26.1 Secondary hyperaldosteronism
E26.8 Other hyperaldosteronism
Bartter's syndrome
E26.9 Hyperaldosteronism, unspecified

E27 Other disorders of adrenal gland
E27.0 Other adrenocortical overactivity
Overproduction of ACTH, not associated with Cushing's disease
Premature adrenarche
Excludes: Cushing's syndrome ( E24.- )
E27.1 Primary adrenocortical insufficiency
Addison's disease
Autoimmune adrenalitis
Excludes: amyloidosis ( E85.- )
tuberculous Addison's disease ( A18.7 )
Waterhouse-Friderichsen syndrome ( A39.1 )
E27.2 Addisonian crisis
Adrenal crisis
Adrenocortical crisis
E27.3 Drug-induced adrenocortical insufficiency
Use additional external cause code (Chapter XX), if desired, to identify drug.
E27.4 Other and unspecified adrenocortical insufficiency
· haemorrhage
· infarction
Adrenocortical insufficiency NOS
Excludes: adrenoleukodystrophy [Addison-Schilder] ( E71.3 )
Waterhouse-Friderichsen syndrome ( A39.1 )
E27.5 Adrenomedullary hyperfunction
Adrenomedullary hyperplasia
Catecholamine hypersecretion
E27.8 Other specified disorders of adrenal gland
Abnormality of cortisol-binding globulin
E27.9 Disorder of adrenal gland, unspecified

E28 Ovarian dysfunction
Excludes: isolated gonadotropin deficiency ( E23.0 )
postprocedural ovarian failure ( E89.4 )
E28.0 Estrogen excess
Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.
E28.1 Androgen excess
Hypersecretion of ovarian androgens
Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.
E28.2 Polycystic ovarian syndrome
Sclerocystic ovary syndrome
Stein-Leventhal syndrome
E28.3 Primary ovarian failure
Decreased estrogen
Premature menopause NOS
Resistant ovary syndrome
Excludes: menopausal and female climacteric states ( N95.1 )
pure gonadal dysgenesis ( Q99.1 )
Turner's syndrome ( Q96.- )
E28.8 Other ovarian dysfunction
Ovarian hyperfunction NOS
E28.9 Ovarian dysfunction, unspecified

E29 Testicular dysfunction
Excludes: androgen resistance syndrome ( E34.5 )
azoospermia or oligospermia NOS ( N46 )
isolated gonadotropin deficiency ( E23.0 )
Klinefelter's syndrome ( Q98.0-Q98.2 , Q98.4 )
postprocedural testicular hypofunction ( E89.5 )
testicular feminization (syndrome) ( E34.5 )
E29.0 Testicular hyperfunction
Hypersecretion of testicular hormones
E29.1 Testicular hypofunction
5-Alpha-reductase deficiency (with male pseudohermaphroditism)
Defective biosynthesis of testicular androgen NOS
Testicular hypogonadism NOS
Use additional external cause code (Chapter XX), if desired, to identify drug, if drug-induced.
E29.8 Other testicular dysfunction
E29.9 Testicular dysfunction, unspecified

E30 Disorders of puberty, not elsewhere classified
E30.0 Delayed puberty
Constitutional delay of puberty
Delayed sexual development
E30.1 Precocious puberty

Precocious menstruation
Premature menarche
Excludes: Albright(-McCune)(-Sternberg) syndrome ( Q78.1 )
central precocious puberty ( E22.8 )
congenital adrenal hyperplasia ( E25.0 )
female heterosexual precocious pseudopuberty ( E25.- )
male isosexual precocious pseudopuberty ( E25.- )
E30.8 Other disorders of puberty
Premature thelarche
E30.9 Disorder of puberty, unspecified

E31 Polyglandular dysfunction
Excludes: ataxia telangiectasia [Louis-Bar] ( G11.3 )
dystrophia myotonica [Steinert] ( G71.1 )
pseudohypoparathyroidism ( E20.1 )
E31.0 Autoimmune polyglandular failure
Schmidt's syndrome
E31.1 Polyglandular hyperfunction
Excludes: multiple endocrine adenomatosis ( D44.8 )
E31.8 Other polyglandular dysfunction
E31.9 Polyglandular dysfunction, unspecified

E32 Diseases of thymus
Excludes: aplasia or hypoplasia with immunodeficiency ( D82.1 )
myasthenia gravis ( G70.0 )
E32.0 Persistent hyperplasia of thymus
Hypertrophy of thymus
E32.1 Abscess of thymus
E32.8 Other diseases of thymus
E32.9 Disease of thymus, unspecified

E34 Other endocrine disorders
Excludes: pseudohypoparathyroidism ( E20.1 )
E34.0 Carcinoid syndrome
Note: May be used as an additional code, if desired, to identify functional activity associated with a carcinoid tumour.
E34.1 Other hypersecretion of intestinal hormones
E34.2 Ectopic hormone secretion, not elsewhere classified
E34.3 Short stature, not elsewhere classified


Short stature:
· associated with chronic illness
· constitutional
· familial
· genetic
· Laron-type
· psychosocial
Excludes: progeria ( E34.8 )
Russell-Silver syndrome ( Q87.1 )
short-limbed stature with immunodeficiency ( D82.2 )
short stature:
· achondroplastic ( Q77.4 )
· hypochondroplastic ( Q77.4 )
· in specific dysmorphic syndromes - code to syndrome - see Alphabetical Index
· nutritional ( E45 )
· pituitary ( E23.0 )
· renal ( N25.0 )
E34.4 Constitutional tall stature
Constitutional gigantism
E34.5 Androgen resistance syndrome
Male pseudohermaphroditism with androgen resistance
Peripheral hormonal receptor disorder
Reifenstein's syndrome
Testicular feminization (syndrome)
E34.8 Other specified endocrine disorders
Pineal gland dysfunction
E34.9 Endocrine disorder, unspecified
· endocrine NOS
· hormone NOS

E35* Disorders of endocrine glands in diseases classified elsewhere
E35.0* Disorders of thyroid gland in diseases classified elsewhere
Tuberculosis of thyroid gland ( A18.8+ )
E35.1* Disorders of adrenal glands in diseases classified elsewhere
Tuberculous Addison's disease ( A18.7+ )
Waterhouse-Friderichsen syndrome (meningococcal) ( A39.1+ )
E35.8* Disorders of other endocrine glands in diseases classified elsewhere