ICD-10 Coding for Goiter(E04.2, E05.00)
Complete ICD-10-CM coding and documentation guide for Goiter. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Goiter
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E04.2 | Nontoxic multinodular goiter | Use when there are multiple thyroid nodules and normal thyroid function tests. |
|
| E05.00 | Thyrotoxicosis with diffuse goiter without mention of thyrotoxic crisis or storm | Use for diffuse goiter with hyperthyroidism symptoms and lab confirmation. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for nontoxic multinodular goiter
Essential facts and insights about Goiter
Primary ICD-10-CM Codes for goiter
Decision Criteria
clinical Criteria
- Presence of multiple thyroid nodules with normal thyroid function tests
Applicable To
- Multinodular goiter without thyrotoxicosis
Excludes
- Toxic multinodular goiter (E05.2)
Clinical Validation Requirements
- Ultrasound showing multiple nodules
- Normal TSH and T4 levels
Code-Specific Risks
- Misclassification as toxic goiter if thyrotoxicosis is present
Coding Notes
- Ensure documentation specifies 'nontoxic' and 'multinodular' to avoid misclassification.
E05.00 - Thyrotoxicosis with diffuse goiter without mention of thyrotoxic crisis or storm
Use for diffuse goiter with hyperthyroidism symptoms and lab confirmation.
Applicable To
- Graves' disease with diffuse goiter
Excludes
- Thyrotoxic crisis or storm (E05.01)
Clinical Validation Requirements
- Suppressed TSH, elevated T4
- Positive TRAb
Coding Notes
Ensure hyperthyroidism is documented to justify E05.00.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Goiter to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E04.2.
Impact
Clinical: May lead to inappropriate treatment decisions., Regulatory: Non-compliance with documentation standards., Financial: Potential for denied claims due to insufficient documentation.
Mitigation Strategy
Ensure all lab results are included in the patient's chart., Use standardized templates for documentation.
Impact
Reimbursement: May result in lower reimbursement due to incorrect coding., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data affecting patient records.
Mitigation Strategy
Use E05.xx for toxic goiter cases.
Impact
High risk of audit if unspecified codes are used without justification.
Mitigation Strategy
Always use the most specific code available.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Goiter, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Goiter
Use these documentation templates to ensure complete and accurate documentation for Goiter. These templates include all required elements for proper coding and billing.
Nontoxic Multinodular Goiter
Specialty: EndocrinologyRequired Elements
- Patient symptoms
- Physical examination findings
- Ultrasound results
- Thyroid function tests
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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