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ICD-10 Guide
ICD-10 CodesE05.1

E05.1

Billable

Thyrotoxicosis with toxic single thyroid nodule

BILLABLE STATUSYes
IMPLEMENTATION DATEOctober 1, 2015
LAST UPDATED09/05/2025

Code Description

ICD-10 E05.1 is a billable code used to indicate a diagnosis of thyrotoxicosis with toxic single thyroid nodule.

Key Diagnostic Point:

Thyrotoxicosis with toxic single thyroid nodule refers to a condition where an overactive thyroid nodule produces excess thyroid hormones, leading to symptoms of hyperthyroidism. This condition is characterized by elevated levels of thyroid hormones in the bloodstream, which can result from a solitary nodule that autonomously secretes these hormones. Patients may present with symptoms such as weight loss, increased appetite, anxiety, tremors, heat intolerance, and palpitations. Diagnosis typically involves thyroid function tests, including serum TSH, free T4, and T3 levels, alongside imaging studies like ultrasound to identify the nodule. Management may include antithyroid medications, radioactive iodine therapy, or surgical intervention, depending on the size of the nodule and the severity of symptoms. It is crucial to differentiate this condition from other forms of hyperthyroidism, such as Graves' disease or multinodular goiter, to ensure appropriate treatment.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between toxic nodules and other forms of hyperthyroidism.
  • Need for comprehensive thyroid function tests interpretation.
  • Potential overlap with other thyroid disorders requiring careful documentation.
  • Variability in clinical presentation among patients.

Audit Risk Factors

  • Inadequate documentation of the nodule's characteristics.
  • Failure to document thyroid function test results.
  • Misclassification of the type of hyperthyroidism.
  • Lack of imaging study reports in the medical record.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Thorough documentation of thyroid function tests, imaging results, and clinical symptoms.

Common Clinical Scenarios

Patients presenting with symptoms of hyperthyroidism and a palpable thyroid nodule.

Billing Considerations

Endocrinologists must ensure that all relevant lab results and imaging studies are included in the patient's record to support the diagnosis.

Primary Care

Documentation Requirements

Documentation of patient history, physical examination findings, and referral notes to specialists.

Common Clinical Scenarios

Initial evaluation of patients with symptoms suggestive of hyperthyroidism.

Billing Considerations

Primary care providers should document any referrals to endocrinology for further evaluation and management.

Coding Guidelines

Inclusion Criteria

Use E05.1 When
  • According to ICD
  • 10 guidelines, E05
  • 1 should be used when there is clear documentation of thyrotoxicosis due to a toxic single thyroid nodule
  • It is important to ensure that the diagnosis is confirmed through appropriate laboratory and imaging studies

Exclusion Criteria

Do NOT use E05.1 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

85025CPT Code

Thyroid function tests

Clinical Scenario

Used to evaluate thyroid hormone levels in patients suspected of having thyrotoxicosis.

Documentation Requirements

Document the rationale for testing and results.

Specialty Considerations

Endocrinologists may require additional tests such as TSH receptor antibodies.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of thyroid disorders, including the differentiation of thyrotoxicosis types, which aids in better patient management and reimbursement accuracy.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thyroid disorders, including the differentiation of thyrotoxicosis types, which aids in better patient management and reimbursement accuracy.

Reimbursement & Billing Impact

reimbursement accuracy.

Resources

Clinical References

  • •
    American Thyroid Association Guidelines

Coding & Billing References

  • •
    American Thyroid Association Guidelines

Frequently Asked Questions

What are the common symptoms of thyrotoxicosis with a toxic single thyroid nodule?

Common symptoms include weight loss, increased appetite, anxiety, tremors, heat intolerance, and palpitations.

How is thyrotoxicosis with a toxic single thyroid nodule diagnosed?

Diagnosis is made through thyroid function tests showing elevated T4 and T3 levels with suppressed TSH, along with imaging studies like ultrasound to identify the nodule.