ICD-10 Coding for Thyroid Lesion(E04.1, E05.10, E05.11)
Complete ICD-10-CM coding and documentation guide for Thyroid Lesion. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Thyroid Lesion
E04-E05Primary Range
Disorders of thyroid gland
This range includes codes for both nontoxic and toxic thyroid nodules, which are relevant for coding thyroid lesions.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E04.1 | Nontoxic single thyroid nodule | Use when a single thyroid nodule is confirmed to be nontoxic with normal thyroid function tests. |
|
| E05.10 | Thyrotoxicosis with toxic single thyroid nodule without thyrotoxic crisis or storm | Use when a single thyroid nodule is toxic, indicated by suppressed TSH and elevated thyroid hormones. |
|
| E05.11 | Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm | Use when a toxic nodule is present with clinical signs of thyrotoxic crisis. |
|
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 thyroid lesion
Essential facts and insights about Thyroid Lesion
Primary ICD-10-CM Codes for thyroid lesion
Decision Criteria
clinical Criteria
- Normal TSH and ultrasound findings consistent with a colloid nodule.
Applicable To
- Colloid nodule
- Nontoxic uninodular goiter
Excludes
- Toxic single thyroid nodule (E05.10)
Clinical Validation Requirements
- Normal TSH levels
- Ultrasound showing colloid nodule
Code-Specific Risks
- Incorrectly coding a toxic nodule as nontoxic.
Coding Notes
- Ensure documentation specifies nontoxic status to avoid misclassification.
E05.10 - Thyrotoxicosis with toxic single thyroid nodule without thyrotoxic crisis or storm
Use when a single thyroid nodule is toxic, indicated by suppressed TSH and elevated thyroid hormones.
Applicable To
- Toxic adenoma
Excludes
- Nontoxic single thyroid nodule (E04.1)
Clinical Validation Requirements
- Suppressed TSH
- Elevated T4/T3
- Thyroid scan showing hyperfunctioning nodule
Coding Notes
Ensure documentation includes lab results confirming thyrotoxicosis.
E05.11 - Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm
Use when a toxic nodule is present with clinical signs of thyrotoxic crisis.
Clinical Validation Requirements
- Suppressed TSH
- Elevated T4/T3
- Clinical signs of thyrotoxic crisis
Coding Notes
Document crisis symptoms clearly to justify this code.
Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Thyroid Lesion to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E04.1.
Impact
Clinical: Misclassification of nodule type., Regulatory: Non-compliance with coding standards., Financial: Potential claim denials.
Mitigation Strategy
Ensure lab results are included in patient records., Cross-check documentation before coding.
Impact
Reimbursement: Incorrect coding may lead to claim denials., Compliance: Non-compliance with ICD-10 coding guidelines., Data Quality: Inaccurate clinical data reporting.
Mitigation Strategy
Verify thyroid function tests to confirm nontoxic status before coding.
Impact
Risk of misclassifying toxic nodules as nontoxic.
Mitigation Strategy
Verify thyroid function tests and document findings clearly.
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 Thyroid Lesion, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Thyroid Lesion
Use these documentation templates to ensure complete and accurate documentation for Thyroid Lesion. These templates include all required elements for proper coding and billing.
Nontoxic Thyroid Nodule
Specialty: EndocrinologyRequired Elements
- Nodule size and location
- TSH levels
- Ultrasound findings
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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