Otolaryngology Coding Alert

ICD-10:

Narrow Six 244.x Hypothyroidism Options to Five ICD-10 Codes in 2014

Your physician will have to think about the hypothyroidism cause.

Hypothyroidism is a condition in which there is too little thyroid hormone in the bloodstream. Hypothyroidism is a common condition and is very treatable. Symptoms can include slowed heart rate, tiredness, inability to tolerate cold, mental fatigue, and constipation.

ICD-9-CM Codes: Right now, you should report this condition with 244.x (Acquired hypothyroidism), which break down as follows:

  • 244.0, Postsurgical hypothyroidism
  • 244.1, Other postablative hypothyroidism
  • 244.2, Iodine hypothyroidism
  • 244.3, Other iatrogenic hypothyroidism
  • 244.8, Other specified acquired hypothyroidism
  • 244.9, Unspecified acquired hypothyroidism 

ICD-9-CM has six codes for various types of acquired hypothyroidism. All possible diagnoses for acquired hypothyroidism are grouped together, which helps simplify your code selection.

ICD-10 Codes: In 2014, you’ll have to make the shift to the following five codes:

  • E89.0, Postprocedural hypothyroidism
  • E03.2, Hypothyroidism due to medicaments and other exogenous substances
  • E01.8, Other iodine-deficiency related thyroid disorders and allied conditions
  • E03.8, Other specified hypothyroidism
  • E03.9, Hypothyroidism, unspecified

Change: Here’s how the equivalencies work out:

  • 244.0 and 244.1 convert to E89.0
  • 244.2 and 244.3 convert to E03.2
  • 244.8 converts to either E01.8 or E03.8
  • 244.9 converts to E03.9 

Most ICD-10 choices are in the subsection Disorders of Thyroid Gland, but E89.0 falls under codes for Postprocedural Endocrine and Metabolic Complications and Disorders.

Documentation: Physicians will need to learn that some of the hypothyroidism diagnoses they’ve reported separately for years will be grouped together in ICD-10. They’ll need to think in terms of whether the patient’s condition was caused by postprocedure circumstances, medicaments or other substances, iodine deficiency, or other specified cause. The final choice is for unspecified hypothyroidism. Remember that some insurance companies won’t reimburse for “unspecified” codes. The more detailed the physician’s documentation can be, the better your chances of correct coding and reimbursement. 

Coder Tips: On your superbill, after acquired hypothyroidism, list each of the five new coding choices. Include notations to prompt the physician to enter the necessary information. Abbreviated options could include:

  • XXXX, Postproc hypothyroidism
  • XXXX, Hypothyroidism med/exogenous sub
  • XXXX, Iodine-def thyroid disorders/conditions
  • XXXX, Other spec hypothyroidism
  • XXXX, Hypothyroidism, unspec