ICD-10 Coding for Hyperthyroidism(E05.00, E05.01, E05.10)
Complete ICD-10-CM coding and documentation guide for Hyperthyroidism. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Hyperthyroidism
E05Primary Range
Thyrotoxicosis [hyperthyroidism]
This range includes all forms of hyperthyroidism, including Graves' disease and toxic nodular goiter.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E05.00 | Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm | Use when Graves' disease is diagnosed without evidence of a thyrotoxic crisis. |
|
| E05.01 | Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm | Use when a thyrotoxic crisis is documented in a patient with Graves' disease. |
|
| E05.10 | Thyrotoxicosis with toxic single thyroid nodule | Use when a single toxic thyroid nodule is documented as the cause of hyperthyroidism. |
|
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 Graves' disease
Essential facts and insights about Hyperthyroidism
Primary ICD-10-CM Codes for hyperthyroidism
Decision Criteria
clinical Criteria
- Patient presents with symptoms of hyperthyroidism and diffuse goiter.
Applicable To
- Graves' disease without crisis
Excludes
- Thyrotoxic crisis or storm (E05.01)
Clinical Validation Requirements
- Suppressed TSH levels
- Elevated T4 and/or T3 levels
- Diffuse goiter on physical exam or imaging
Code-Specific Risks
- Misclassification if crisis symptoms are present but not documented
Coding Notes
- Ensure documentation specifies the absence of a thyrotoxic crisis.
E05.01 - Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm
Use when a thyrotoxic crisis is documented in a patient with Graves' disease.
Applicable To
- Graves' disease with crisis
Clinical Validation Requirements
- Suppressed TSH levels
- Elevated T4 and/or T3 levels
- Symptoms of thyrotoxic crisis such as tachycardia >140 BPM, hyperthermia >102°F
Coding Notes
Ensure crisis symptoms are clearly documented.
E05.10 - Thyrotoxicosis with toxic single thyroid nodule
Use when a single toxic thyroid nodule is documented as the cause of hyperthyroidism.
Applicable To
- Toxic adenoma
Excludes
- Nontoxic single thyroid nodule (E04.1)
Clinical Validation Requirements
- Suppressed TSH levels
- Elevated T4 and/or T3 levels
- Single toxic nodule confirmed by imaging
Coding Notes
Ensure imaging confirms the presence of a toxic nodule.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Hyperthyroidism to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E05.00.
Impact
Clinical: Leads to under-treatment of severe cases., Regulatory: Non-compliance with coding standards., Financial: Potential loss of reimbursement for crisis management.
Mitigation Strategy
Ensure thorough documentation of crisis symptoms., Regular training on crisis identification.
Impact
Reimbursement: Incorrect coding can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Impacts accuracy of patient records.
Mitigation Strategy
Use specific codes like E05.00 for Graves' disease.
Impact
Inaccurate coding of thyrotoxic crisis can lead to audit issues.
Mitigation Strategy
Ensure clear documentation of crisis symptoms and lab results.
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 Hyperthyroidism, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Hyperthyroidism
Use these documentation templates to ensure complete and accurate documentation for Hyperthyroidism. These templates include all required elements for proper coding and billing.
Graves' disease management
Specialty: EndocrinologyRequired Elements
- Patient history
- Physical examination findings
- Laboratory results
- Imaging studies
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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