ICD-10 Coding for Thyroid Nodule(E04.1, E05.10)
Complete ICD-10-CM coding and documentation guide for Thyroid Nodule. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Thyroid Nodule
E04.0-E04.9Primary Range
Other nontoxic goiter
This range includes codes for nontoxic thyroid nodules, which are the most common presentations.
Thyrotoxicosis [hyperthyroidism]
This range includes codes for toxic thyroid nodules, which are less common but clinically significant.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E04.1 | Nontoxic single thyroid nodule | Use when a single thyroid nodule is present without signs of hyperthyroidism. |
|
| E05.10 | Thyrotoxicosis with toxic single thyroid nodule without crisis | Use when a single thyroid nodule is present with suppressed TSH and hyperthyroid symptoms. |
|
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 nontoxic thyroid nodule
Essential facts and insights about Thyroid Nodule
Primary ICD-10-CM Codes for thyroid nodule
Decision Criteria
clinical Criteria
- Normal TSH levels and single nodule on ultrasound
Applicable To
- Single thyroid nodule without hyperthyroidism
Excludes
- Toxic single thyroid nodule (E05.10)
Clinical Validation Requirements
- Normal TSH levels
- Ultrasound showing single nodule
Code-Specific Risks
- Misclassification if hyperthyroidism is present
Coding Notes
- Ensure TSH levels are documented to differentiate from toxic nodules.
E05.10 - Thyrotoxicosis with toxic single thyroid nodule without crisis
Use when a single thyroid nodule is present with suppressed TSH and hyperthyroid symptoms.
Applicable To
- Toxic single thyroid nodule
Excludes
- Nontoxic single thyroid nodule (E04.1)
Clinical Validation Requirements
- Suppressed TSH levels
- Symptoms of hyperthyroidism
Coding Notes
Document suppressed TSH and hyperthyroid symptoms clearly.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Thyroid Nodule to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E04.1.
Impact
Clinical: Ambiguity in treatment planning., Regulatory: Potential audit issues., Financial: Claims may be denied for lack of specificity.
Mitigation Strategy
Always document the side of the thyroid affected., Use templates that prompt for laterality.
Impact
Reimbursement: Incorrect coding may lead to denied claims., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Use E05.10 if TSH is suppressed and hyperthyroid symptoms are present.
Impact
Incorrect coding of thyroid nodules can lead to audits.
Mitigation Strategy
Ensure TSH levels and nodule characteristics are documented.
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 Thyroid Nodule, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Thyroid Nodule
Use these documentation templates to ensure complete and accurate documentation for Thyroid Nodule. These templates include all required elements for proper coding and billing.
Single Nontoxic Thyroid Nodule
Specialty: EndocrinologyRequired Elements
- Nodule size and location
- TSH levels
- Ultrasound findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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