From the Research
The ICD-10 code for increased thirst is R63.1, which specifically represents polydipsia. This code falls under the category of symptoms and signs involving food and fluid intake. When documenting increased thirst in a medical record, it's essential to note that this code should be used when the symptom cannot be attributed to a specific underlying condition. If the increased thirst is due to a known cause such as diabetes mellitus, the primary condition should be coded instead. For example, if a patient has excessive thirst due to diabetes, the appropriate diabetes code (such as E11.9 for type 2 diabetes) would be the primary diagnosis.
Key Considerations
- The underlying physiology of increased thirst often involves the hypothalamus and posterior pituitary, which regulate fluid balance through antidiuretic hormone (ADH) 1.
- Disruptions in this system, whether from disease processes or medications, can trigger the sensation of thirst as the body attempts to maintain proper hydration status.
- According to a study published in Nature Reviews Disease Primers in 2019, diabetes insipidus (DI) is a disorder characterized by excretion of large amounts of hypotonic urine, and central DI results from a deficiency of the hormone arginine vasopressin (AVP) in the pituitary gland or the hypothalamus 1.
Diagnosis and Treatment
- Distinguishing between the different types of DI can be challenging and is done either by a water deprivation test or by hypertonic saline stimulation together with copeptin (or AVP) measurement 1.
- Treatment of DI or primary polydipsia depends on the underlying aetiology and differs in central DI, nephrogenic DI, and primary polydipsia 1.
- Desmopressin is recognized as the drug of choice for central diabetes insipidus, with a greatly enhanced therapeutic profile, allowing more specific antidiuresis without adverse reactions 2.
Clinical Implications
- When using the ICD-10 code R63.1, clinicians should document the severity, duration, and any associated symptoms like increased urination or dry mouth to provide a complete clinical picture.
- The management of central diabetes insipidus has been greatly simplified by the introduction of desmopressin (DDAVP), with its ease of administration, safety, and tolerability making it the first-line agent for outpatient treatment of central diabetes insipidus 3.