Frequency Limitations:
Testing may be covered up to two times a year in clinically stable patients; more frequent testing may be reasonable and necessary for patients whose thyroid therapy has been altered or in whom symptoms or signs of hyperthyroidism or hypothyroidism are noted.
CPT CODES:80091Thyroid panel, includes Thyroxine, total (84436) and Thyroid
hormone (T3 or T4) uptake or thyroid hormone binding ration (84479)
80092Thyroid panel with TSH
84436Thyroxine, total
84439Thyroxine Free
84443Thyroid Stimulating Hormone (TSH)
84479Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)
CMS (Medicare) has determined that Thyroid Testing (CPT Codes 84436, 84439, 84443, 84479) is only medically necessary and, therefore, reimbursable by Medicare when ordered for patients with any of the diagnostic conditions listed below in the “ICD-9-CM Codes Covered by Medicare Program.” If you are ordering this test for a diagnostic condition other than those listed below, please have your patient sign and date an Advanced Beneficiary Notice (ABN). All ICD-9-CM codes provided must be consistent with the documentation in the patient’s medical records for the date of service.
ICD 10 Code Description
D64.9 Anemia, unspecified
E03.8 Other specified hypothyroidism
E03.9 Hypothyroidism, unspecified
E05.90
Thyrotoxicosis, unspecified without thyrotoxic crisis or
storm
E07.9 Disorder of thyroid, unspecified
E11.65 Type 2 diabetes mellitus with hyperglycemia
E11.9 Type 2 diabetes mellitus without complications
E78.0 Pure hypercholesterolemia
E78.2 Mixed hyperlipidemia
E78.4 Other hyperlipidemia
E78.5 Hyperlipidemia, unspecified
F32.9 Major depressive disorder, single episode, unspecified
I10 Essential (primary) hypertension
I48.91 Unspecified atrial fibrillation
I50.9 Heart failure, unspecified
R53.81 Other malaise
R53.82 Chronic fatigue, unspecified
R53.83 Other fatigue
R63.4 Abnormal weight loss
Z79.899 Other long term (current) drug therapy
COVERED DIAGNOSIS:
193Malignant neoplasm of thyroid gland
198.82Secondary malignant neoplasm of genital organs
198.89Secondary malignant neoplasm of other specified site
226Benign neoplasm of thyroid glands
227.3Pituitary gland and craniopharyngeal duct (pouch)
234.8Carcinoma in situ of other specified sites
237.0Neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct
237.4Neoplasm of uncertain behavior of other and unspecified endocrine glands
239.7Neoplasm of unspecified nature, endocrine glands and other parts of nervous system
240.0-240.9Simple and unspecified goiter
241.0-241.9Nontoxic nodular goiter
242.00-242.91Thyrotoxicosis with or without goiter
243Congenital hypothyroidism
244.0-244.9Acquired hypothyroidism
245.0-245.9Thyroiditis
246.0-246.9Other disorders of thyroid
252.1Hypoparathyroidism
253.1Other and unspecified anterior pituitary hyperfunction
253.2Panhypopituitarism
253.3Pituitary dwarfism
253.4Other anterior pituitary disorders
253.7Iatrogenic pituitary disorders
255.2Adrenogenital disorders
255.3Other corticoadrenal overactivity
255.4Corticoadrenal insufficiency
256.3Other ovarian failure
257.2Other testicular hypofunction
258.0-258.9Polyglandular activity in multiple endocrine adenomatosis, up to and including
polyglandular dysfunction, unspecified
266.0Deficiency of B-complex components ariboflavinosis
272.0Pure hypercholesterolemia
272.1Pure hyperglyceridemia
272.2Mixed hyperlipidemia
272.4Other and unspecified hyperlipidemia
275.40-275.49 Disorders of calcium metabolism
276.1Hyposmolality and/or hyponatremia
278.00Obesity, unspecified
278.01Morbid obesity
290.0Senile dementia, uncomplicated
290.10-290.13Presenile dementia
290.20-290.21Senile dementia with delusional or depressive features
290.3Senile dementia with delirium
292.89Other specified drug-induced mental disorders
293.0-293.1Acute and subacute delirium
293.81-293.89Other specified transient organic mental disorders
293.9Unspecified transient organic mental disorders
294.0Amnestic syndrome
294.10-294.11 Dementia in conditions classified elsewhere
294.8Other specified organic brain syndromes (chronic)
294.9Unspecified organic brain syndrome (chronic)
295.00-295.95Schizophrenic disorders
296.00-296.99Affective psychoses
297.1Paronoia
298.8Other and unspecified reactive psychosis
298.9Unspecified psychosis
300.00-300.02Anxiety states, up to generalized anxiety disorder
300.81Somatization disorder
301.13Cyclothymic disorder
307.1Anorexia nervosa
307.51Bulimia
310.1Organic personality syndrome
311Depressive disorder, not elsewhere classified
331.0-331.2Other cerebral degenerations
333.1Essential and other specified forms of tremor
333.5Other choreas
354.0Carpal tunnel syndrome
356.9Hereditary and idiopathic peripheral neuropathy, unspecified
357.8Inflammatory and toxic neuropathy; other
358.1Myasthenic syndromes in diseases classified elsewhere
359.5Myopathy in endocrine diseases classified elsewhere
368.2Diplopia
374.41Lid retraction or lag
374.82Edema of eyelid
376.21Thyrotoxic exophthalmos
376.22Exophthalmic ophthalmoplegia
376.30Exophthalmos, unspecified
376.31Constant exophthalmos
376.33Orbital edema or congestion
376.34Intermittent exophthalmos
376.35Pulsating exophthalmos
389.10-389.18Sensorineural hearing loss
389.2Mixed conductive and senorineural hearing loss
401.0-401.9Hypertension
423.9Unspecified disease of pericardium
425.7Nutritional and metabolic cardiomyopathy
427.0Paroxysmal supraventricular tachycardia
427.2Paroxysmal tachycardia, unspecified
427.31Atrial fibrillation
427.32Atrial flutter
427.60-427.61Premature beats
427.81-427.89Other specified cardiac dysrhythmias
427.9Cardiac dysrhythmia, unspecified
428.0Congestive heart failure
428.1Left heart failure
429.2Cardiovascular disease, unspecified
429.3Cardiomegaly
560.1Paralytic ileus
564.0Constipation
564.5Functional diarrhea
564.7Megacolon, other than Hirschsprung’s
611.1Hypertrophy of breast
611.6Galactorrhea not associated with childbirth
625.3Dysmenorrhea
626.0-626.2Disorders of menstruation and other abnormal bleeding, female genital tract
626.4Irregular menstrual cycle
626.6Metrorrhagia
626.8Disorders of menstruation and other abnormal bleeding from female genital tract, other
648.10-648.14 Other current conditions in the mother, classifiable elsewhere, but complicating
pregnancy, childbirth, or the puerperium, thyroid dysfunction
676.20-676.24Engorgement of breast associated with childbirth and disorders of lactation
698.9Pruritus
701.1Keratoderma, acquired (dry skin)
703.8Other specified diseases of nail (brittle nails)
704.00Alopecia, unspecified
709.01Vitiligo
710.0Systemic lupus erythematosus
710.1Systemic sclerosis
710.2Sicca syndrome
714.0Rheumatoid arthritis
716.90-716.99Arthropathy, unspecified
728.9Unspecified disorder of muscle, ligament, and fascia
729.1Myalgia and myositis, unspecified
729.82Cramp
730.30-730.39 Periostitis without mention of osteomyelitis
733.00-733.03Osteoporosis
733.09Osteoporosis, drug induced
750.15Macroglossia
759.2Anomalies of other endocrine glands
775.3Neonatal thyrotoxicosis
780.09Alteration of consciousness, other
780.1Hallucinations
780.51-780.53Sleep disturbances
780.57Other and unspecified sleep apnea
780.79Other malaise and fatigue
780.8Hyperhidrosis
780.9Malaise and fatigue, other general symptoms
781.0Abnormal involuntary movements
781.3Lack of coordination
782.3Edema
782.8Changes in skin texture
783.1Abnormal weight gain
783.21Abnormal loss of weight
784.1Throat pain
784.49Voice disturbance, other
785.0Tachycardia, unspecified
785.1Palpitations
787.2Dysphagia
787.99Other symptoms involving digestive system, other
790.6Other abnormal blood chemistry, lithium
793.2Other intrathoracic organ
794.5Nonspecific abnormal results, thyroid
796.1Abnormal reflex
799.2Nervousness
990Effects of radiation, unspecified
995.2Unspecified adverse effect of drug, medicinal and biological substance
V10.87Personal history of malignant neoplasm of thyroid
V18.1Other endocrine and metabolic diseases
V58.69Long term (current) use of other medications
V77.7Other inborn errors of metabolism
Testing may be covered up to two times a year in clinically stable patients; more frequent testing may be reasonable and necessary for patients whose thyroid therapy has been altered or in whom symptoms or signs of hyperthyroidism or hypothyroidism are noted.
CPT CODES:80091Thyroid panel, includes Thyroxine, total (84436) and Thyroid
hormone (T3 or T4) uptake or thyroid hormone binding ration (84479)
80092Thyroid panel with TSH
84436Thyroxine, total
84439Thyroxine Free
84443Thyroid Stimulating Hormone (TSH)
84479Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR)
CMS (Medicare) has determined that Thyroid Testing (CPT Codes 84436, 84439, 84443, 84479) is only medically necessary and, therefore, reimbursable by Medicare when ordered for patients with any of the diagnostic conditions listed below in the “ICD-9-CM Codes Covered by Medicare Program.” If you are ordering this test for a diagnostic condition other than those listed below, please have your patient sign and date an Advanced Beneficiary Notice (ABN). All ICD-9-CM codes provided must be consistent with the documentation in the patient’s medical records for the date of service.
ICD 10 Code Description
D64.9 Anemia, unspecified
E03.8 Other specified hypothyroidism
E03.9 Hypothyroidism, unspecified
E05.90
Thyrotoxicosis, unspecified without thyrotoxic crisis or
storm
E07.9 Disorder of thyroid, unspecified
E11.65 Type 2 diabetes mellitus with hyperglycemia
E11.9 Type 2 diabetes mellitus without complications
E78.0 Pure hypercholesterolemia
E78.2 Mixed hyperlipidemia
E78.4 Other hyperlipidemia
E78.5 Hyperlipidemia, unspecified
F32.9 Major depressive disorder, single episode, unspecified
I10 Essential (primary) hypertension
I48.91 Unspecified atrial fibrillation
I50.9 Heart failure, unspecified
R53.81 Other malaise
R53.82 Chronic fatigue, unspecified
R53.83 Other fatigue
R63.4 Abnormal weight loss
Z79.899 Other long term (current) drug therapy
COVERED DIAGNOSIS:
193Malignant neoplasm of thyroid gland
198.82Secondary malignant neoplasm of genital organs
198.89Secondary malignant neoplasm of other specified site
226Benign neoplasm of thyroid glands
227.3Pituitary gland and craniopharyngeal duct (pouch)
234.8Carcinoma in situ of other specified sites
237.0Neoplasm of uncertain behavior of pituitary gland and craniopharyngeal duct
237.4Neoplasm of uncertain behavior of other and unspecified endocrine glands
239.7Neoplasm of unspecified nature, endocrine glands and other parts of nervous system
240.0-240.9Simple and unspecified goiter
241.0-241.9Nontoxic nodular goiter
242.00-242.91Thyrotoxicosis with or without goiter
243Congenital hypothyroidism
244.0-244.9Acquired hypothyroidism
245.0-245.9Thyroiditis
246.0-246.9Other disorders of thyroid
252.1Hypoparathyroidism
253.1Other and unspecified anterior pituitary hyperfunction
253.2Panhypopituitarism
253.3Pituitary dwarfism
253.4Other anterior pituitary disorders
253.7Iatrogenic pituitary disorders
255.2Adrenogenital disorders
255.3Other corticoadrenal overactivity
255.4Corticoadrenal insufficiency
256.3Other ovarian failure
257.2Other testicular hypofunction
258.0-258.9Polyglandular activity in multiple endocrine adenomatosis, up to and including
polyglandular dysfunction, unspecified
266.0Deficiency of B-complex components ariboflavinosis
272.0Pure hypercholesterolemia
272.1Pure hyperglyceridemia
272.2Mixed hyperlipidemia
272.4Other and unspecified hyperlipidemia
275.40-275.49 Disorders of calcium metabolism
276.1Hyposmolality and/or hyponatremia
278.00Obesity, unspecified
278.01Morbid obesity
290.0Senile dementia, uncomplicated
290.10-290.13Presenile dementia
290.20-290.21Senile dementia with delusional or depressive features
290.3Senile dementia with delirium
292.89Other specified drug-induced mental disorders
293.0-293.1Acute and subacute delirium
293.81-293.89Other specified transient organic mental disorders
293.9Unspecified transient organic mental disorders
294.0Amnestic syndrome
294.10-294.11 Dementia in conditions classified elsewhere
294.8Other specified organic brain syndromes (chronic)
294.9Unspecified organic brain syndrome (chronic)
295.00-295.95Schizophrenic disorders
296.00-296.99Affective psychoses
297.1Paronoia
298.8Other and unspecified reactive psychosis
298.9Unspecified psychosis
300.00-300.02Anxiety states, up to generalized anxiety disorder
300.81Somatization disorder
301.13Cyclothymic disorder
307.1Anorexia nervosa
307.51Bulimia
310.1Organic personality syndrome
311Depressive disorder, not elsewhere classified
331.0-331.2Other cerebral degenerations
333.1Essential and other specified forms of tremor
333.5Other choreas
354.0Carpal tunnel syndrome
356.9Hereditary and idiopathic peripheral neuropathy, unspecified
357.8Inflammatory and toxic neuropathy; other
358.1Myasthenic syndromes in diseases classified elsewhere
359.5Myopathy in endocrine diseases classified elsewhere
368.2Diplopia
374.41Lid retraction or lag
374.82Edema of eyelid
376.21Thyrotoxic exophthalmos
376.22Exophthalmic ophthalmoplegia
376.30Exophthalmos, unspecified
376.31Constant exophthalmos
376.33Orbital edema or congestion
376.34Intermittent exophthalmos
376.35Pulsating exophthalmos
389.10-389.18Sensorineural hearing loss
389.2Mixed conductive and senorineural hearing loss
401.0-401.9Hypertension
423.9Unspecified disease of pericardium
425.7Nutritional and metabolic cardiomyopathy
427.0Paroxysmal supraventricular tachycardia
427.2Paroxysmal tachycardia, unspecified
427.31Atrial fibrillation
427.32Atrial flutter
427.60-427.61Premature beats
427.81-427.89Other specified cardiac dysrhythmias
427.9Cardiac dysrhythmia, unspecified
428.0Congestive heart failure
428.1Left heart failure
429.2Cardiovascular disease, unspecified
429.3Cardiomegaly
560.1Paralytic ileus
564.0Constipation
564.5Functional diarrhea
564.7Megacolon, other than Hirschsprung’s
611.1Hypertrophy of breast
611.6Galactorrhea not associated with childbirth
625.3Dysmenorrhea
626.0-626.2Disorders of menstruation and other abnormal bleeding, female genital tract
626.4Irregular menstrual cycle
626.6Metrorrhagia
626.8Disorders of menstruation and other abnormal bleeding from female genital tract, other
648.10-648.14 Other current conditions in the mother, classifiable elsewhere, but complicating
pregnancy, childbirth, or the puerperium, thyroid dysfunction
676.20-676.24Engorgement of breast associated with childbirth and disorders of lactation
698.9Pruritus
701.1Keratoderma, acquired (dry skin)
703.8Other specified diseases of nail (brittle nails)
704.00Alopecia, unspecified
709.01Vitiligo
710.0Systemic lupus erythematosus
710.1Systemic sclerosis
710.2Sicca syndrome
714.0Rheumatoid arthritis
716.90-716.99Arthropathy, unspecified
728.9Unspecified disorder of muscle, ligament, and fascia
729.1Myalgia and myositis, unspecified
729.82Cramp
730.30-730.39 Periostitis without mention of osteomyelitis
733.00-733.03Osteoporosis
733.09Osteoporosis, drug induced
750.15Macroglossia
759.2Anomalies of other endocrine glands
775.3Neonatal thyrotoxicosis
780.09Alteration of consciousness, other
780.1Hallucinations
780.51-780.53Sleep disturbances
780.57Other and unspecified sleep apnea
780.79Other malaise and fatigue
780.8Hyperhidrosis
780.9Malaise and fatigue, other general symptoms
781.0Abnormal involuntary movements
781.3Lack of coordination
782.3Edema
782.8Changes in skin texture
783.1Abnormal weight gain
783.21Abnormal loss of weight
784.1Throat pain
784.49Voice disturbance, other
785.0Tachycardia, unspecified
785.1Palpitations
787.2Dysphagia
787.99Other symptoms involving digestive system, other
790.6Other abnormal blood chemistry, lithium
793.2Other intrathoracic organ
794.5Nonspecific abnormal results, thyroid
796.1Abnormal reflex
799.2Nervousness
990Effects of radiation, unspecified
995.2Unspecified adverse effect of drug, medicinal and biological substance
V10.87Personal history of malignant neoplasm of thyroid
V18.1Other endocrine and metabolic diseases
V58.69Long term (current) use of other medications
V77.7Other inborn errors of metabolism
