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ICD-10 Guide
ICD-10 CodesChapter 4: Endocrine, nutritional and metabolic diseasesE05

E05

Billable

Thyrotoxicosis [hyperthyroidism]

Chapter 4:Endocrine, nutritional and metabolic diseases

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

Code Description

ICD-10 E05 is a billable code used to indicate a diagnosis of thyrotoxicosis [hyperthyroidism].

Key Diagnostic Point:

Thyrotoxicosis, commonly referred to as hyperthyroidism, is a condition characterized by an excess of thyroid hormones in the bloodstream, leading to an accelerated metabolism and a range of systemic effects. The most common cause of thyrotoxicosis is Graves' disease, an autoimmune disorder that stimulates the thyroid gland to produce excessive amounts of thyroid hormones. Other causes include toxic multinodular goiter, thyroiditis, and excessive intake of iodine or thyroid hormone medications. Symptoms often include weight loss, increased appetite, heat intolerance, anxiety, tremors, and palpitations. Diagnosis typically involves clinical evaluation, thyroid function tests (TFTs) measuring levels of Thyroid Stimulating Hormone (TSH), Free T4, and Free T3. Management may involve antithyroid medications, radioactive iodine therapy, or surgical intervention, depending on the underlying cause and severity of the condition. Monitoring thyroid function tests is crucial in managing treatment and preventing complications such as thyroid storm, a life-threatening exacerbation of hyperthyroidism.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiating between various causes of hyperthyroidism
  • Understanding the nuances of thyroid function tests
  • Managing co-existing conditions that may affect thyroid function
  • Documentation of symptoms and treatment response

Audit Risk Factors

  • Inadequate documentation of symptoms and lab results
  • Failure to specify the underlying cause of hyperthyroidism
  • Incorrect coding of associated conditions
  • Lack of follow-up documentation for treatment efficacy

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed documentation of thyroid function tests, symptoms, and treatment plans.

Common Clinical Scenarios

Patients presenting with weight loss, anxiety, and palpitations; follow-up visits for medication management.

Billing Considerations

Ensure accurate coding of the underlying cause of hyperthyroidism and any associated conditions.

Primary Care

Documentation Requirements

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

Common Clinical Scenarios

Initial evaluation of hyperthyroid symptoms, referral to endocrinology.

Billing Considerations

Documenting the rationale for referrals and any preliminary treatments initiated.

Coding Guidelines

Inclusion Criteria

Use E05 When
  • Follow the official ICD
  • CM coding guidelines, ensuring accurate documentation of the condition's etiology
  • Include relevant lab results and clinical findings to support the diagnosis

Exclusion Criteria

Do NOT use E05 When
  • Exclude conditions that do not meet the criteria for E05

Related CPT Codes

84443CPT Code

Thyroid function tests

Clinical Scenario

Used to evaluate thyroid hormone levels in patients suspected of hyperthyroidism.

Documentation Requirements

Document the rationale for testing and results.

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 hyperthyroidism, enabling better tracking of causes and treatment outcomes. This specificity aids in research and improves patient care.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of hyperthyroidism, enabling better tracking of causes and treatment outcomes. This specificity aids in research and improves patient care.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of hyperthyroidism, enabling better tracking of causes and treatment outcomes. This specificity aids in research and improves patient care.

Resources

Clinical References

  • •
    American Thyroid Association Guidelines

Coding & Billing References

  • •
    American Thyroid Association Guidelines

Frequently Asked Questions

What are the common causes of thyrotoxicosis?

Common causes include Graves' disease, toxic multinodular goiter, thyroiditis, and excessive iodine intake. Each cause may require different management strategies.