Metabolic syndrome

This code identifies metabolic syndrome, a cluster of conditions that occur together, increasing the risk of heart disease, stroke, and type 2 diabetes. It is characterized by at least three of the following medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low high-density lipoprotein (HDL) cholesterol.

Use this code when a patient has been formally diagnosed with metabolic syndrome by a physician. Documentation should clearly indicate the presence of multiple components of the syndrome that meet diagnostic criteria, even if individual components are also coded separately.

• Do not code individual components of metabolic syndrome (e.g., obesity, hypertension) as the primary diagnosis if metabolic syndrome is documented as the overarching condition.
• Ensure physician documentation explicitly states "metabolic syndrome" rather than just listing its components.
• Consider sequencing this code as the primary diagnosis when it is the main reason for the encounter, followed by codes for specific manifestations or complications.