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ICD-10 Guide
ICD-10 CodesE05.20

E05.20

Billable

Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm

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

Code Description

ICD-10 E05.20 is a billable code used to indicate a diagnosis of thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm.

Key Diagnostic Point:

Thyrotoxicosis with toxic multinodular goiter is a condition characterized by the excessive production of thyroid hormones due to the presence of multiple hyperfunctioning nodules in the thyroid gland. This condition is often seen in patients with a history of iodine deficiency or those who have developed nodular goiter over time. Unlike thyrotoxic crisis or storm, which is a life-threatening exacerbation of hyperthyroidism, E05.20 indicates a more stable state of hyperthyroidism where the patient may present with symptoms such as weight loss, increased appetite, heat intolerance, and palpitations. Diagnosis typically involves thyroid function tests, including serum TSH, free T4, and T3 levels, which will show suppressed TSH and elevated thyroid hormones. Management may include antithyroid medications, radioactive iodine therapy, or surgical intervention depending on the severity of symptoms and the size of the goiter. Regular monitoring of thyroid function tests is essential to assess treatment efficacy and adjust therapy as needed.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various types of hyperthyroidism
  • Understanding the nuances of thyroid function tests
  • Identifying the presence of nodules versus diffuse goiter
  • Documenting the absence of thyrotoxic crisis

Audit Risk Factors

  • Inadequate documentation of thyroid function test results
  • Failure to specify the absence of thyrotoxic crisis
  • Misclassification of the type of goiter present
  • Lack of follow-up documentation on treatment response

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

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

Common Clinical Scenarios

Patients presenting with symptoms of hyperthyroidism, routine follow-ups for thyroid function monitoring.

Billing Considerations

Ensure clear documentation of the type of goiter and any associated symptoms to support the diagnosis.

Primary Care

Documentation Requirements

Comprehensive patient history, physical examination findings, and lab results.

Common Clinical Scenarios

Initial evaluation of hyperthyroid symptoms, referrals to specialists.

Billing Considerations

Documenting the patient's history of iodine intake and any previous thyroid issues.

Coding Guidelines

Inclusion Criteria

Use E05.20 When
  • According to ICD
  • 10 guidelines, E05
  • 20 should be used when a patient has thyrotoxicosis due to toxic multinodular goiter without any acute exacerbation
  • Documentation must support the diagnosis with clear evidence of thyroid function tests and clinical symptoms

Exclusion Criteria

Do NOT use E05.20 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

84443CPT Code

Thyroid stimulating hormone (TSH)

Clinical Scenario

Used to evaluate thyroid function in patients suspected of hyperthyroidism.

Documentation Requirements

Document the reason for testing and any relevant clinical findings.

Specialty Considerations

Endocrinologists may require more detailed lab results for treatment planning.

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, improving the accuracy of diagnoses and treatment plans. E05.20 provides a clear distinction between types of thyrotoxicosis, which aids in better patient management and resource allocation.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thyroid disorders, improving the accuracy of diagnoses and treatment plans. E05.20 provides a clear distinction between types of thyrotoxicosis, which aids in better patient management and resource allocation.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of thyroid disorders, improving the accuracy of diagnoses and treatment plans. E05.20 provides a clear distinction between types of thyrotoxicosis, which aids in better patient management and resource allocation.

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 toxic multinodular goiter?

Common symptoms include weight loss, increased appetite, heat intolerance, palpitations, anxiety, and tremors. Patients may also present with a visible goiter.