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ICD-10 Guide
ICD-10 CodesE05.21

E05.21

Billable

Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm

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

Code Description

ICD-10 E05.21 is a billable code used to indicate a diagnosis of thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm.

Key Diagnostic Point:

Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm is a severe and life-threatening condition characterized by an excessive release of thyroid hormones into the bloodstream, resulting in a hypermetabolic state. This condition typically arises in patients with multinodular goiter, where multiple nodules in the thyroid gland produce excess thyroid hormones autonomously. A thyrotoxic crisis, also known as thyroid storm, is an acute exacerbation of hyperthyroidism, presenting with symptoms such as fever, tachycardia, agitation, and altered mental status. The crisis can be precipitated by stressors such as infection, surgery, or trauma. Diagnosis is confirmed through clinical evaluation and laboratory tests showing elevated levels of free T4 and suppressed TSH. Management includes the use of antithyroid medications, beta-blockers, and supportive care. Prompt recognition and treatment are crucial to prevent complications and improve patient outcomes.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of thyroid function tests and their interpretation.
  • Involves distinguishing between various forms of hyperthyroidism.
  • Need for precise documentation of clinical presentation and laboratory results.
  • Potential for overlap with other thyroid disorders, necessitating careful coding.

Audit Risk Factors

  • Inadequate documentation of the acute nature of the thyrotoxic crisis.
  • Failure to document precipitating factors leading to the crisis.
  • Lack of clarity in distinguishing between different types of hyperthyroidism.
  • Insufficient detail in laboratory results related to thyroid function tests.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed clinical notes on thyroid function tests, imaging studies, and treatment plans.

Common Clinical Scenarios

Patients presenting with symptoms of hyperthyroidism, management of thyroid storm, and follow-up of multinodular goiter.

Billing Considerations

Ensure comprehensive documentation of all thyroid function tests and any precipitating factors for the thyrotoxic crisis.

Emergency Medicine

Documentation Requirements

Immediate documentation of vital signs, clinical presentation, and interventions performed.

Common Clinical Scenarios

Patients presenting with acute symptoms of thyrotoxicosis, requiring rapid assessment and treatment.

Billing Considerations

Document all emergency interventions and the patient's response to treatment to support coding for acute conditions.

Coding Guidelines

Inclusion Criteria

Use E05.21 When
  • According to ICD
  • 10 coding guidelines, E05
  • 21 should be used when there is clear documentation of thyrotoxicosis due to toxic multinodular goiter accompanied by a thyrotoxic crisis
  • It is essential to document the clinical presentation, laboratory findings, and treatment provided to support the use of this code

Exclusion Criteria

Do NOT use E05.21 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

84443CPT Code

Thyroid function tests (TSH, T4)

Clinical Scenario

Used to confirm diagnosis of thyrotoxicosis.

Documentation Requirements

Document the rationale for testing and results.

Specialty Considerations

Endocrinologists should ensure comprehensive lab results are included.

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 enhances the accuracy of patient records and reimbursement processes.

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 enhances the accuracy of patient records and reimbursement processes.

Reimbursement & Billing Impact

reimbursement processes.

Resources

Clinical References

  • •
    American Thyroid Association Guidelines

Coding & Billing References

  • •
    American Thyroid Association Guidelines

Frequently Asked Questions

What are the common symptoms of thyrotoxicosis?

Common symptoms include weight loss, rapid heartbeat, increased appetite, sweating, anxiety, and tremors. In severe cases, symptoms may escalate to fever, confusion, and agitation.