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ICD-10 Guide
ICD-10 CodesE05.11

E05.11

Billable

Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm

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

Code Description

ICD-10 E05.11 is a billable code used to indicate a diagnosis of thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm.

Key Diagnostic Point:

Thyrotoxicosis with a toxic single thyroid nodule is a condition characterized by excessive thyroid hormone production due to a hyperfunctioning nodule within the thyroid gland. This condition can lead to a thyrotoxic crisis or storm, a life-threatening exacerbation of hyperthyroidism that requires immediate medical attention. Patients may present with symptoms such as palpitations, anxiety, tremors, heat intolerance, weight loss, and increased appetite. In severe cases, symptoms can escalate to fever, tachycardia, and altered mental status. The diagnosis is typically confirmed through thyroid function tests, which reveal elevated levels of free thyroxine (FT4) and suppressed thyroid-stimulating hormone (TSH). Imaging studies, such as a thyroid scan, may be utilized to identify the toxic nodule. Management often involves antithyroid medications, beta-blockers for symptomatic relief, and in some cases, radioactive iodine therapy or surgery. Understanding the nuances of this condition is crucial for accurate coding and appropriate patient management.

Code Complexity Analysis

Complexity Rating: High

High Complexity

Complexity Factors

  • Requires understanding of thyroid function tests and their interpretation.
  • Involves distinguishing between different types of hyperthyroidism.
  • Management options can vary significantly based on patient presentation.
  • Documentation must clearly indicate the presence of a toxic nodule and thyrotoxic crisis.

Audit Risk Factors

  • Inadequate documentation of the toxic nodule.
  • Failure to document the acute nature of the thyrotoxic crisis.
  • Misinterpretation of thyroid function test results.
  • Lack of clarity in treatment plans and patient management.

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Thorough documentation of thyroid function tests, imaging results, and treatment plans.

Common Clinical Scenarios

Patients presenting with symptoms of hyperthyroidism, requiring evaluation of thyroid nodules.

Billing Considerations

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

Internal Medicine

Documentation Requirements

Detailed history and physical examination findings, including vital signs and symptom assessment.

Common Clinical Scenarios

Management of acute thyrotoxic crisis in hospitalized patients.

Billing Considerations

Internal medicine physicians should document the acute presentation and any interventions performed.

Coding Guidelines

Inclusion Criteria

Use E05.11 When
  • According to ICD
  • 10 guidelines, E05
  • 11 should be used when there is clear documentation of a toxic single thyroid nodule and the presence of a thyrotoxic crisis
  • It is essential to ensure that the clinical documentation supports the diagnosis and that any relevant lab results are included

Exclusion Criteria

Do NOT use E05.11 When
No specific exclusions found.

Related ICD-10 Codes

Related CPT Codes

84443CPT Code

Thyroid stimulating hormone (TSH)

Clinical Scenario

Used to assess thyroid function in patients suspected of thyrotoxicosis.

Documentation Requirements

Document the reason for the test and any relevant clinical findings.

Specialty Considerations

Endocrinologists should ensure that TSH levels are interpreted in the context of FT4 results.

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 with toxic nodules. This specificity improves data accuracy and enhances the ability to track treatment outcomes.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of thyroid disorders, including the differentiation of thyrotoxicosis with toxic nodules. This specificity improves data accuracy and enhances the ability to track treatment outcomes.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of thyroid disorders, including the differentiation of thyrotoxicosis with toxic nodules. This specificity improves data accuracy and enhances the ability to track treatment outcomes.

Resources

Clinical References

  • •
    American Thyroid Association Guidelines

Coding & Billing References

  • •
    American Thyroid Association Guidelines

Frequently Asked Questions

What are the key symptoms of a thyrotoxic crisis?

Key symptoms include fever, tachycardia, altered mental status, and severe agitation. Patients may also experience gastrointestinal symptoms such as nausea and vomiting.