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Chronic elevation of cortisol levels can lead to a pseudo-Cushings syndrome, which is characterised by increased visceral adiposity, hyperinsulinaemia, insulin resistance, hyper tension and dyslipidaemia, all of which are hallmarks of metabolic syndrome

Typically in outpatient clinics the physician assigns ICD-9 codes for visits, whereas patients admitted to the hospital are assigned codes by a team of professional billers in consultation with the physician and the medical record