Sarcoidosis is a rare condition that causes inflammation of body tissues. It is an inflammatory disease wherein granulomas or clumps of inflammatory cells (that cause small patches of red and swollen tissue) develop in different parts or organs of the body. In most cases, these granulomas clear up, either with or without treatment. On the other hand, in some cases wherein 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 this condition is a difficult task as many patients are asymptomatic. Even when Symptoms do occur (in some cases), they mimic those of other disorders. Billing and coding for this inflammatory disease is quite challenging, as there are several rules that go along with this condition. For accurate clinical documentation of this disorder, most physicians rely on the services of reliable medical billing outsourcing companies.

Here are some frequently asked questions and answers about sarcoidosis –

Q: Who gets sarcoidosis?
A: This condition can affect people of any age group, but symptoms normally appear in people in the age group of 20- 40 years. It is more common in women than men. It rarely occurs in children.

Q: What are the main causes for this disease?
A: The exact cause of sarcoidosis is unknown. It 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.

Q: Which organs are affected by sarcoidosis?
A: This condition usually affects the lungs, skin, eyes and lymph nodes. However, it can also affect the liver, brain, heart, nervous system, spleen and other internal organs (even though less common). For this reason sarcoidosis is classified as a multisystem disorder.

Q: What are the initial signs and symptoms of sarcoidosis?
A: The immediate signs and symptoms may vary and depend on which specific organs are affected. For some patients, the symptoms may develop suddenly and disappear within a few months or years (and the condition may not reappear). For some other people, symptoms develop gradually and last for years and get worse over time. However, some people don’t show any symptoms at all and the condition may be diagnosed only via an X-ray that is taken for some other reasons. Some of the general symptoms include –

• Fatigue
• Fever
• Weight loss
• Tiredness and a general feeling of being unwell
• Swollen lymph nodes
• Painful joints
• Pain in the bones

Skin symptoms

• Growths under the skin (nodules), particularly around scars or tattoos
• Disfiguring sores (lesions) on the nose, cheeks and ears
• Areas of skin (darker or lighter in color)
• A rash of red or reddish-purple bumps (usually located on the shins or ankles)

Eye symptoms

• A burning sensation in your eyes
• A discharge from your eyes
• Blurred vision
• Dry or itchy eyes
• Eye pain
• Sensitivity to light
• Severe redness

Lung symptoms

• Wheezing
• Shortness of breath
• Rapid or fluttering heart beat
• Persistent dry cough
• Irregular heartbeats
• Fainting (syncope)
• Chest pain

Q: What are the potential complications?
A: In most cases, people who suffer from sarcoidosis don’t experience any serious complications. However, the condition can become chronic in the long-term. Complications may include –

• Lung infection
• Cataracts (characterized by a clouding of the lens of your eye)
• Glaucoma (a group of eye diseases that can cause blindness)
• Kidney failure
• Abnormal heart beat
• Facial paralysis
• Infertility or difficulty conceiving

Q: How is sarcoidosis diagnosed, treated and documented?
A: Diagnosing this inflammatory disease is a very difficult process, as many symptoms can be similar to those of other diseases. The initial diagnosis will begin with a detailed physical examination which helps to check for – for skin bumps or rash, look for Swollen Lymph Nodes and to check for enlarged liver or spleen. This may be followed by 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 addition, physicians may conduct blood tests to check for kidney and liver function.

Most people with sarcoidosis do not need treatment as the condition often goes away on its own, usually within a few months or years. Incorporating healthy lifestyle changes and taking over-the counter medications can help to control symptoms in a better manner. These can include corticosteroids or immunosuppressive medications which can both help reduce inflammation. Pulmonologists who provide specialized treatment 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
offered by reputable companies can help physicians in using the correct codes for their medical billing process.

Q: What ICD-10 codes are used for diagnosing sarcoidosis?
A: The following ICD-10 codes are relevant with regard to “sarcoidosis” –

D86 – Sarcoidosis
• D86.0 – Sarcoidosis of lung/li>
• D86.1 – Sarcoidosis of lymph nodes/li>
• D86.2 – Sarcoidosis of lung with sarcoidosis of lymph nodes/li>
• D86.3 – Sarcoidosis of skin/li>
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

Q: What are the lifestyle measures I can adopt to prevent sarcoidosis?
A: Preventing sarcoidosis requires people to follow or incorporate several lifestyle changes such as –

• Avoid or stop smoking
• Avoid exposure to dust, chemicals, fumes and toxic gases
• Eat a healthy balanced diet
• Drink plenty of water
• Get adequate sleep and proper exercise.

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