ICD-10 Coding for High Thyroid Stimulating Hormone(E03.9, E06.3, E89.0)
Complete ICD-10-CM coding and documentation guide for High Thyroid Stimulating Hormone. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to High Thyroid Stimulating Hormone
E03Primary Range
Other hypothyroidism
This range includes codes for various types of hypothyroidism, including unspecified and autoimmune causes.
Thyroiditis
This range includes codes for thyroiditis, including autoimmune thyroiditis, which is a common cause of elevated TSH.
Postprocedural endocrine and metabolic disorders
This range includes codes for post-ablative hypothyroidism, which can result in elevated TSH levels.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E03.9 | Hypothyroidism, unspecified | Use when TSH is elevated but no specific cause is documented. |
|
| E06.3 | Autoimmune thyroiditis | Use when autoimmune thyroiditis is confirmed by lab tests and clinical findings. |
|
| E89.0 | Postprocedural hypothyroidism | Use when hypothyroidism follows surgical or ablative treatment. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for high TSH
Essential facts and insights about High Thyroid Stimulating Hormone
Primary ICD-10-CM Codes for high thyroid stimulating hormone
Decision Criteria
clinical Criteria
- TSH >4.5 µIU/mL with normal free T4
documentation Criteria
- Absence of specific etiology in documentation
Applicable To
- Subclinical hypothyroidism
- Acquired hypothyroidism
Excludes
- Congenital hypothyroidism (E03.0)
Clinical Validation Requirements
- TSH >4.5 µIU/mL on 2+ tests
- Normal free T4 levels
- Absence of specific etiology
Code-Specific Risks
- May lead to undercoding if specific etiology is known but not documented.
Coding Notes
- Ensure documentation specifies hypothyroidism and not just 'high TSH'.
E06.3 - Autoimmune thyroiditis
Use when autoimmune thyroiditis is confirmed by lab tests and clinical findings.
Applicable To
- Hashimoto's thyroiditis
Excludes
- Acute thyroiditis (E06.0)
Clinical Validation Requirements
- Positive TPO antibodies
- Lymphocytic infiltration on biopsy
Coding Notes
Document autoimmune etiology clearly to justify this code.
E89.0 - Postprocedural hypothyroidism
Use when hypothyroidism follows surgical or ablative treatment.
Applicable To
- Post-thyroidectomy hypothyroidism
Excludes
- Hypothyroidism due to other causes (E03.-)
Clinical Validation Requirements
- History of thyroidectomy or RAI
- Elevated TSH post-procedure
Coding Notes
Ensure linkage to surgical history is documented.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Abnormal thyroid function studies
R94.6Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting High Thyroid Stimulating Hormone to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E03.9.
Impact
Clinical: May lead to misdiagnosis of hypothyroidism type., Regulatory: Non-compliance with documentation standards., Financial: Potential for claim denial or reduced reimbursement.
Mitigation Strategy
Ensure TPO antibody tests are ordered and results documented., Educate providers on importance of complete documentation.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate data on hypothyroidism etiology.
Mitigation Strategy
Use E89.0 with Z90.1 to specify post-surgical cause.
Impact
Reimbursement: Potential for claim denial due to lack of specificity., Compliance: Violates coding rules requiring provider confirmation., Data Quality: Leads to incomplete clinical data.
Mitigation Strategy
Query provider for confirmation of hypothyroidism.
Impact
Frequent use of E03.9 without documented etiology.
Mitigation Strategy
Encourage detailed documentation of hypothyroidism causes.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for High Thyroid Stimulating Hormone, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for High Thyroid Stimulating Hormone
Use these documentation templates to ensure complete and accurate documentation for High Thyroid Stimulating Hormone. These templates include all required elements for proper coding and billing.
Subclinical Hypothyroidism
Specialty: EndocrinologyRequired Elements
- TSH and free T4 levels
- Symptoms or lack thereof
- Exclusion of other causes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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