Secondary hyperparathyroidism of renal origin

This code signifies an overproduction of parathyroid hormone (PTH) that occurs as a direct consequence of chronic kidney disease (CKD). The impaired renal function leads to imbalances in calcium and phosphorus metabolism, stimulating the parathyroid glands to secrete excess PTH. This condition is distinct from primary hyperparathyroidism, where the parathyroid glands themselves are the primary cause of the overactivity.

Use this code when documentation clearly links hyperparathyroidism to underlying renal failure or chronic kidney disease. This typically involves elevated PTH levels in a patient with a diagnosis of CKD, often accompanied by abnormal calcium and phosphorus levels. Documentation should specify "secondary hyperparathyroidism of renal origin" or similar phrasing.

• Always ensure the medical record explicitly states the renal origin of the secondary hyperparathyroidism to differentiate it from non-renal causes.
• Sequence this code after the underlying chronic kidney disease (e.g., N18.x) when both conditions are present and treated.
• Be mindful of the Excludes1 note; do not code this with E21.1 (secondary hyperparathyroidism, non-renal).