Sarcoidosis is the growth of tiny inflammatory cells (granulomas) in different parts of your body — most commonly the lungs, lymph nodes, eyes and skin. All symptoms of sarcoidosis must be documented with correct ICD-10 codes to prevent claim denials.

1. Sarcoidosis is the growth of tiny inflammatory
cells (granulomas) in different parts of your
body — most commonly the lungs, lymph nodes,
eyes and skin. All symptoms of sarcoidosis must
be documented with correct ICD-10 codes to
prevent claim denials.
Sarcoidosis Diagnosis
and Coding
– An Overview of ICD-10 Codes

2. Sarcoidosis is an inflammatory disease where in granulomas or clumps of
inflammatory cells (that cause small patches of red and swollen tissue) get
developed in different parts or organs of the body. The areas of the body
commonly affected by sarcoidosis include - lymph nodes, lungs, eyes and
skin. Even though less common, sarcoidosis can also affect the heart, liver,
brain and spleen. The exact cause of sarcoidosis is unknown. The condition
may be triggered by your body’s immune system responding to substances
such as viruses, bacteria, dust or chemicals. However, gender, race and
genetics can increase the potential risk of developing this condition.
As sarcoidosis progresses, microscopic lumps of a specific form of
inflammation, called granulomas, appear in the affected tissues. In most of
the cases, these granulomas clear up, either with or without treatment. On
the other hand, in some cases, where in the granulomas do not heal and
disappear, the tissues tend to remain inflamed, become scarred (fibrotic)
and cause organ damage. Early and accurate diagnosis of sarcoidosis is
challenging, as many patients are asymptomatic. Even when symptoms do
occur (in some cases), they mimic those of other disorders. Prognosis is
variable and may depend on epidemiologic factors, mode of onset, initial
clinical course, and specific organ involvement. With appropriate and timely
treatment combined with simple lifestyle changes and medications, it is
possible to control the pain of disease flare-ups. For accurate clinical
documentation of this disorder, physicians can benefit from the services of
medical billing outsourcing companies.
What Are the Symptoms of Sarcoidosis?
The signs and symptoms associated with this condition may vary depending
on which organs are affected or involved. For some people, the symptoms
may develop suddenly, but disappear within a few months or years and the
condition doesn't come back. On the other hand, for some people symptoms

3. develop gradually, last for years and get worse over time. Many people don’t
even depict any symptoms at all, and the condition may be diagnosed after
an X-ray carried out for another reason. For many people, sarcoidosis begins
with the following general symptoms –
 Fatigue
 Fever
 Swollen lymph nodes
 Weight loss
 Tiredness and a general feeling of being unwell
 Painful joints
 Pain in the bones
Lung symptoms
 Persistent dry cough
 Shortness of breath
 Wheezing
 Chest pain
 Fainting (syncope)
 Irregular heartbeats
 Rapid or fluttering heart beat
Skin symptoms
 Blurred vision
 Eye pain
 Severe redness
 Sensitivity to light
 A rash of red or reddish-purple bumps (usually located on the shins or
ankles)
 Disfiguring sores (lesions) on the nose, cheeks and ears

4.  Areas of skin (darker or lighter in color)
 Growths under the skin (nodules), particularly around scars or tattoos
Eye symptoms
 Dry or itchy eyes
 A burning sensation in your eyes
 A discharge from your eyes
Sarcoidosis can affect people of any age group, but symptoms normally
appear in people between the age group of 20- 40 years. It is more common
in women than men. This condition rarely occurs in children.
Diagnosing and Coding for Sarcoidosis
Diagnosing sarcoidosis is a very difficult process as the immediate signs and
symptoms can be similar to those of other diseases. Physicians need to run a
variety of tests to make a correct diagnosis about the disorder. The initial
part of the diagnosis will most likely begin with a detailed physical
examination (including a close examination of any skin lesions). The detailed
physical exam will help to check –
 For skin bumps or a rash
 For an enlarged liver or spleen
 Look for swollen lymph nodes
 Listen to heart and lungs
Based on these findings, physicians may conduct additional diagnostic tests
like - Chest X-ray (to find for granulomas and swollen lymph nodes),
Computerized tomography (CT scan), Lung (pulmonary) function tests,
Positron emission tomography (PET) scan or Magnetic resonance imaging
(MRI) (to check if sarcoidosis is affecting your heart or central nervous
system) and biopsies (taking a sample of tissue to check for granulomas). In

5. addition, physician may conduct blood tests to check for kidney and liver
function.
Most cases of sarcoidosis don't require treatment as the condition often goes
away on its own, usually within a few months or years. Simple lifestyle
changes and over-the-counter medications can help to control the symptoms
in a better manner. Pulmonologists providing specific treatments are
reimbursed for the services provided to the patients. Correct medical codes
must be used to document the diagnosis, screening and other procedures
performed. Medical billing and coding services provided by reputable
companies can help physicians in using the correct codes for their medical
billing process. The following ICD-10 codes are relevant with regard to
“sarcoidosis” –
D86 - Sarcoidosis
 D86.0 - Sarcoidosis of lung
 D86.1 - Sarcoidosis of lymph nodes
 D86.2 - Sarcoidosis of lung with sarcoidosis of lymph nodes
 D86.3 - Sarcoidosis of skin
D86.8 - Sarcoidosis of other sites
 D86.81 - Sarcoid meningitis
 D86.82 - Multiple cranial nerve palsies in sarcoidosis
 D86.83 - Sarcoid iridocyclitis
 D86.84 - Sarcoid pyelonephritis
 D86.85 - Sarcoid myocarditis
 D86.86 - Sarcoid arthropathy
 D86.87 - Sarcoid myositis
 D86.89 - Sarcoidosis of other sites

6. There is no known cure for sarcoidosis, but in half of the cases, it goes away
on its own. Mild signs can often be effectively managed by making simple
lifestyle changes. Stopping the habit of smoking and avoiding exposure to
dust, chemicals, fumes and toxic gases can help prevent most cases of this
disease. Following a healthy lifestyle integrated with a balanced diet,
adequate exercise and sleep can help prevent the occurrence of this
condition.
For clinicians, accurate medical coding of the condition is important from the
point of view of care provision as well as reimbursement. So, pulmonologists
treating patients with this condition can consider pulmonary medical
billing service provided by an experienced provider. This will help them to
code the condition correctly on their claims and ensure optimal
reimbursement.
Isolated Cardiac Sarcoidosis May Be Rarer than Previously
Suggested – Finds Study
A new study suggests that isolated cardiac sarcoidosis, which refers to
cardiac involvement without the disease clinically apparent, may be rarer
than previously reported. The study results were published in the
International Journal of Cardiology. Researchers evaluated the rate of
isolated cardiac sarcoidosis in a group of patients by imaging the whole body
with a technique called - 18F-fluorodeoxyglucose (FDG) positron emission
tomography and computed tomography (PET-CT). This imaging technique
that is considered a standard method tracks a radio labeled analog of
glucose, a natural sugar in the body. In addition, the team measured the
extent of extra-cardiac sarcoidosis at the time patients developed their first
signs of cardiac symptoms.
The study included a total of 31 Caucasian patients (with a mean age of 56
years), who underwent whole-body and cardiac 18F–FDG PET-CT imaging.

7. As part of the study, researchers classified patients into two different groups
on the basis of their sarcoidosis history. The group included–
 Group 1 – Included 20 patients – with no previous history of
sarcoidosis in any organ
 Group 2 – Included 11 patients – with a remote history of extra-
cardiac sarcoidosis
The key findings of the study include -
 Out of the total 31 patients analyzed, researchers found only one case
of isolated cardiac sarcoidosis, with no signs of sarcoidosis anywhere
else.
 The other 30 patients reported no signs of this disorder in at least one
other organ besides the heart. But the extent proved to be limited and
included signs that were restricted to the lungs. This pattern was
similar when both patient groups were compared.
 Active lung involvement was observed in 45 percent of patients in the
first group, or 9 patients out of 20.
 On the other hand, active lung involvement was detected in about 55
percent of people or 6 patients out of 11 in the second group.
 When compared to patients initially showing extra-cardiac disease, a
statistically significant difference in two parameters of heart function–
(right ventricular and atrial involvement) were found between patients
with cardiac sarcoidosis as their first manifestation.
The study results signify that clinicians and imaging specialists should pay
specific attention to these findings, and how they relate to presentation,
prognosis and arrhythmias. Researchers concluded that out of the two
groups analyzed, most patients depicted limited cardiac involvement at the
time of presentation of manifest CS [cardiac sarcoidosis]. However, isolated
CS, using the proposed gold standard, was only observed in one patient.