Autoimmune thyroiditis, also known as Hashimoto's thyroiditis or chronic lymphocytic thyroiditis, is a common autoimmune disorder. This page provides information on autoimmune thyroiditis diagnosis, including relevant clinical documentation, medical coding, ICD-10 codes, and healthcare best practices for managing this condition. Learn about symptoms, treatment options, and the importance of accurate medical coding for Hashimoto's thyroiditis in clinical settings.
Also known as
Autoimmune thyroiditis
Inflammation of the thyroid gland due to autoimmune response.
Other hypothyroidism
Hypothyroidism not otherwise specified, sometimes caused by autoimmune thyroiditis.
Disorders of thyroid gland in other diseases classified elsewhere
Thyroid disorders associated with other conditions, potentially including autoimmune thyroiditis.
Other specified immunodeficiencies
May include certain immune dysregulations sometimes related to autoimmune diseases like Hashimoto's.
Follow this step-by-step guide to choose the correct ICD-10 code.
Is thyroid function specified (hypo, hyper, etc)?
Yes
Hypothyroidism?
No
Code E06.3, Autoimmune thyroiditis
When to use each related code
| Description |
|---|
| Autoimmune attack of the thyroid gland, often leading to hypothyroidism. |
| Underactive thyroid, producing insufficient thyroid hormones. |
| Overactive thyroid, excessive thyroid hormone production. |
Coding Hashimoto's as unspecified thyroiditis (E06.9) leads to inaccurate severity and treatment reflection impacting reimbursement.
Concurrent goiter presence requires specific coding (E06.3). Missing documentation leads to undercoding and lost revenue.
While common, not all Hashimoto's patients have hypothyroidism. Documenting and coding both separately ensures clinical accuracy (E06.3, E03.9).
Q: What are the most effective diagnostic strategies for differentiating Autoimmune Thyroiditis (Hashimoto's Thyroiditis) from other forms of hypothyroidism in clinical practice?
A: Differentiating Autoimmune Thyroiditis (Hashimoto's Thyroiditis) from other hypothyroid conditions requires a multi-faceted approach. Serum thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels are initial screening tests. Elevated TSH with low or normal FT4 suggests hypothyroidism. However, to pinpoint Hashimoto's, anti-thyroid peroxidase (TPO) antibodies and anti-thyroglobulin (TG) antibodies are essential. Positive TPO antibodies, highly sensitive for Hashimoto's, are often sufficient for diagnosis, especially when combined with the clinical picture. TG antibodies can be supportive but are less specific. Ultrasound can reveal a characteristically heterogeneous and hypoechoic thyroid gland, further supporting the diagnosis. Explore how combining these tests with patient history, including family history of autoimmune diseases and symptoms like fatigue and cold intolerance, can improve diagnostic accuracy. Consider implementing a diagnostic algorithm that includes TSH, FT4, TPO antibody testing, and selective use of TG antibody and ultrasound based on initial findings.
Q: How should I manage subclinical hypothyroidism due to Hashimoto's Thyroiditis in asymptomatic patients, and when is levothyroxine therapy warranted based on current guidelines?
A: Managing subclinical hypothyroidism in asymptomatic Hashimoto's patients involves careful monitoring and shared decision-making. Current guidelines generally recommend against levothyroxine therapy for asymptomatic individuals with mildly elevated TSH (typically between 4.0 and 10.0 mIU/L) and normal FT4. Regular monitoring of TSH and FT4, usually every 6-12 months, is crucial. Levothyroxine therapy should be considered if TSH levels persistently remain above 10 mIU/L, if anti-TPO antibodies are present with a TSH above the upper limit of normal even if below 10.0, or if the patient develops symptoms of hypothyroidism or goiter. Furthermore, women planning pregnancy with subclinical hypothyroidism and positive TPO antibodies should be considered for levothyroxine therapy. Learn more about the latest ATA and European Thyroid Association guidelines regarding the management of subclinical hypothyroidism in Hashimoto's patients. Consider implementing a patient-centered approach that incorporates patient preferences and individual risk factors.
Patient presents with symptoms suggestive of autoimmune thyroiditis, also known as Hashimoto's thyroiditis or chronic lymphocytic thyroiditis. The patient reports experiencing fatigue, weight gain, constipation, dry skin, hair loss, and cold intolerance. Physical examination may reveal a diffusely enlarged, firm, and nontender thyroid gland. Laboratory evaluation demonstrates elevated thyroid peroxidase antibodies (TPOAb) and thyroglobulin antibodies (TgAb). TSH levels may be elevated, normal, or low depending on the stage of the disease. Free T4 and free T3 levels may be normal or low. Ultrasound imaging of the thyroid may show a heterogeneous echotexture with decreased vascularity, consistent with Hashimoto's thyroiditis. Differential diagnosis includes hypothyroidism from other causes, iodine deficiency, and subacute thyroiditis. The diagnosis of autoimmune thyroiditis is based on the combination of clinical presentation, positive thyroid antibody tests, and characteristic ultrasound findings. Treatment typically involves levothyroxine replacement therapy to normalize thyroid hormone levels and alleviate symptoms. Patient education regarding the chronic nature of the disease and the importance of medication adherence is crucial. Monitoring of TSH and free T4 levels will be performed to optimize the levothyroxine dosage. Follow-up appointments are scheduled to assess treatment response and manage potential complications such as myxedema coma or thyroid lymphoma, although the latter is rare. The patient's prognosis with appropriate management is generally good. ICD-10 code E06.3 is used for autoimmune thyroiditis.