ICD-10: E16.3

The ICD-10 code E16.3 refers to "Increased secretion of glucagon," which is a condition characterized by elevated levels of glucagon, a hormone produced by the alpha cells of the pancreas. This condition can be associated with various underlying health issues, including certain types of tumors, diabetes, and other metabolic disorders.

Diagnostic Criteria for Increased Secretion of Glucagon

Clinical Presentation

The diagnosis of increased glucagon secretion typically begins with a thorough clinical evaluation. Key symptoms that may prompt further investigation include:

• Hyperglycemia: Elevated blood glucose levels, which may occur due to glucagon's role in increasing hepatic glucose production.
• Weight Loss: Unexplained weight loss can be a sign of glucagonoma, a rare tumor that secretes glucagon.
• Diabetes Symptoms: Symptoms such as increased thirst, frequent urination, and fatigue may be present, particularly if the glucagon levels are affecting insulin function.

Laboratory Tests

To confirm increased glucagon secretion, several laboratory tests may be conducted:

1. Plasma Glucagon Levels: A fasting plasma glucagon test is essential. Normal glucagon levels typically range from 50 to 100 pg/mL, and levels above this range may indicate increased secretion[1].

2. Blood Glucose Levels: Testing for hyperglycemia is crucial, as elevated glucagon can lead to increased blood sugar levels. This may involve fasting blood glucose tests or glucose tolerance tests[2].

3. C-peptide Levels: Measuring C-peptide can help differentiate between type 1 and type 2 diabetes, as glucagon levels can be influenced by insulin secretion. Low C-peptide levels with high glucagon may suggest type 1 diabetes or glucagonoma[3].

Imaging Studies

In cases where a glucagon-secreting tumor (glucagonoma) is suspected, imaging studies may be necessary:

• CT or MRI Scans: These imaging techniques can help identify pancreatic tumors or other abnormalities that may be causing increased glucagon secretion[4].
• Endoscopic Ultrasound: This may be used for a more detailed view of the pancreas and surrounding structures.

Differential Diagnosis

It is important to rule out other conditions that may cause similar symptoms or laboratory findings. Conditions to consider include:

• Diabetes Mellitus: Both type 1 and type 2 diabetes can present with hyperglycemia and altered glucagon levels.
• Other Endocrine Disorders: Conditions such as Cushing's syndrome or pheochromocytoma may also affect glucagon levels and should be considered in the differential diagnosis[5].

Conclusion

The diagnosis of increased secretion of glucagon (ICD-10 code E16.3) involves a combination of clinical assessment, laboratory testing, and imaging studies to confirm elevated glucagon levels and identify any underlying causes. Early diagnosis is crucial for effective management, particularly if a glucagon-secreting tumor is present. If you suspect increased glucagon secretion, consulting with an endocrinologist or a healthcare provider specializing in metabolic disorders is advisable for comprehensive evaluation and treatment.

References:
1. ICD-10-CM TABULAR LIST of DISEASES and INJURIES.
2. Application of the International Classification of Diseases to clinical practice.
3. Hypoglycemia in Non-Diabetic In-Patients: Clinical or metabolic implications.
4. Billing and Coding: Monitored Anesthesia Care.
5. ICD 10 NCD Manual.