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ICD-10 Guide
ICD-10 CodesE05.4

E05.4

Billable

Thyrotoxicosis factitia

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

Code Description

ICD-10 E05.4 is a billable code used to indicate a diagnosis of thyrotoxicosis factitia.

Key Diagnostic Point:

Thyrotoxicosis factitia is a condition characterized by the presence of excessive thyroid hormones in the body due to the ingestion of exogenous thyroid hormones, often for the purpose of weight loss or to self-treat perceived thyroid dysfunction. This condition can mimic primary hyperthyroidism, leading to symptoms such as weight loss, increased appetite, heat intolerance, palpitations, and anxiety. Patients may present with elevated levels of free thyroxine (T4) and triiodothyronine (T3) in serum thyroid function tests, while thyroid-stimulating hormone (TSH) levels are typically suppressed. The diagnosis is often made through a thorough clinical history, including medication use, and laboratory tests. It is crucial to differentiate thyrotoxicosis factitia from other forms of hyperthyroidism, such as Graves' disease or toxic nodular goiter, as the management and implications differ significantly. Treatment involves cessation of the exogenous hormone intake and monitoring of thyroid function tests to ensure normalization of hormone levels.

Code Complexity Analysis

Complexity Rating: Medium

Medium Complexity

Complexity Factors

  • Differentiation from other hyperthyroid conditions
  • Need for thorough patient history and medication review
  • Potential for misdiagnosis as primary hyperthyroidism
  • Variability in presentation and symptoms

Audit Risk Factors

  • Inadequate documentation of medication history
  • Failure to document thyroid function test results
  • Misclassification of the condition as primary hyperthyroidism
  • Lack of follow-up documentation post-treatment

Specialty Focus

Medical Specialties

Endocrinology

Documentation Requirements

Detailed patient history, including medication use, and comprehensive thyroid function test results.

Common Clinical Scenarios

Patients presenting with symptoms of hyperthyroidism without a clear underlying cause.

Billing Considerations

Endocrinologists must ensure thorough documentation to differentiate between thyrotoxicosis factitia and other hyperthyroid conditions.

Primary Care

Documentation Requirements

Complete patient history and symptom assessment, including any self-medication practices.

Common Clinical Scenarios

Patients with unexplained weight loss and anxiety who may have self-prescribed thyroid medications.

Billing Considerations

Primary care providers should be vigilant in asking about over-the-counter and alternative medications that may contain thyroid hormones.

Coding Guidelines

Inclusion Criteria

Use E05.4 When
  • According to ICD
  • 10 guidelines, E05
  • 4 should be used when the condition is specifically due to the ingestion of exogenous thyroid hormones
  • It is important to document the source of thyroid hormone intake and any relevant laboratory findings

Exclusion Criteria

Do NOT use E05.4 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 suspected cases of thyrotoxicosis.

Documentation Requirements

Document the reason for the test and any relevant symptoms.

Specialty Considerations

Endocrinologists may require additional tests to confirm the diagnosis.

ICD-10 Impact

Diagnostic & Documentation Impact

Enhanced Specificity

ICD-10 Improvements

The transition to ICD-10 has allowed for more specific coding of conditions like thyrotoxicosis factitia, improving the accuracy of diagnoses and treatment tracking.

ICD-9 vs ICD-10

The transition to ICD-10 has allowed for more specific coding of conditions like thyrotoxicosis factitia, improving the accuracy of diagnoses and treatment tracking.

Reimbursement & Billing Impact

The transition to ICD-10 has allowed for more specific coding of conditions like thyrotoxicosis factitia, improving the accuracy of diagnoses and treatment tracking.

Resources

Clinical References

  • •
    American Thyroid Association Guidelines

Coding & Billing References

  • •
    American Thyroid Association Guidelines

Frequently Asked Questions

What is the primary cause of thyrotoxicosis factitia?

The primary cause is the ingestion of exogenous thyroid hormones, often for weight loss or self-treatment of perceived thyroid issues.