ICD-10-CM: 3 Tips for More Accurate Hyperthyroidism Coding

Thu, Nov 29, 2018 --

ICD-10, Skill Sharpener

ICD-10-CM includes a host of codes for hyperthyroidism, and that means your team’s documentation and coding skills need to be sharp. Here are some helpful hints to get you on your way.

Learn Your Terms and Prefixes to Locate Codes

Knowing medical anatomy and terminology is a must for coders, and that includes knowing that the thyroid is a gland located in the front of the neck. It has a sort of butterfly shape, and its job is to produce hormones that affect the speed of the metabolism.

For coding, it’s also important not to get tripped up by the difference between the prefixes hyper- and hypo-:

  • Hyper- indicates “over” or “excess”
  • Hypo- indicates “under.”

For a lot of people, remembering that a hypodermic needle goes under the skin will help with keeping the prefixes separate. Or, for something less technical, thinking of hyper in the layman sense of being overly energetic may be the key.

Bring it all together: Here we’re talking about hyperthyroidism. In simple terms hyperthyroidism is overactive thyroid, in contrast with hypothyroidism, which is underactive thyroid (a topic for another day).

More specifically, in hyperthyroidism, the thyroid produces too much thyroxine hormone, accelerating the metabolism, which can lead to symptoms such as weight loss and irregular heartbeat. Again, this condition is in contrast with hypothyroidism, in which the thyroid doesn’t produce enough hormones, which may lead to obesity, heart disease, and other medical concerns.

Train for These Documentation Clues to Ensure Hyperthyroidism Specificity

You’ll find the codes for hyperthyroidism in E05.- (Thyrotoxicosis [hyperthyroidism]). The fourth character for your code is based on these types:

  • With diffuse goiter (includes exophthalmic or toxic goiter NOS, Graves’ disease, and toxic diffuse goiter)
  • With toxic single thyroid nodule (or toxic uninodular goiter)
  • With toxic multinodular goiter (including toxic nodular goiter NOS)
  • From ectopic thyroid tissue
  • Thyrotoxicosis factitia (caused by taking too much thyroid hormone)
  • Other (including documentation of overproduction of thyroid-stimulating hormone)
  • Unspecified (including hyperthyroidism NOS).

For the fifth character, you’ll need to look for documentation of thyrotoxic crisis or storm.

Example: The descriptors for the E05.0- subcategory look like this:

  • E05.00 (Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm)
  • E05.01 (Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm).

Move Over to P Codes for Newborns

There’s an exception to our discussion of E05.- codes above. When the patient is a newborn, you need to be aware of P72.1 (Transitory neonatal hyperthyroidism), which is appropriate for neonatal thyrotoxicosis.

There’s an Excludes1 note with the E05.- category to help you remember to use P72.1 for the neonatal condition.

Bonus tip: An additional Excludes1 note at E05.- points you to E06.2 for chronic thyroiditis with transient thyrotoxicosis.

What About You?

What are your tips for learning the medical terms that come up in the cases you report?

About 

Deborah works on a wide range of TCI SuperCoder projects, researching and writing about coding, as well as assisting with data updates and tool development for our online coding solutions. Since joining TCI in 2004, she’s covered the ins and outs of coding for radiology, cardiology, oncology and hematology, orthopedics, audiology, and more.

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