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Pathology/Lab Coding Alert

Reader Questions:

Establish Specific Dx for Thyroid Function Tests

Published on Fri Jul 09, 2010

Question: If a physician orders total T4 and TSH tests for a patient with hypothyroidism following thyroid cancer surgery and postsurgical radiation therapy, should we code a thyroid function panel and 244.9 for the diagnosis?North Carolina Subscriber Answer: The correct coding for this case is 84436 (Thyroxine; total) plus 84443 (Thyroid stimulating hormone [TSH]) for the tests, and 244.1 (Acquired hypothyroidism, other postablative hypothyroidism) for the diagnosis.CPT doesn't provide a "thyroid panel" code, so you need to report the ordered tests individually using 84436 and 84443. Physicians often order total thyroxine as total T4 or TT4. Your diagnosis coding should be more precise for this patient, because 244.9 (Unspecified hypothyroidism) does not reflect the postsurgical/post-radiation state of the patient's condition. When the patient has recently had thyroid surgery or radiation therapy that caused the hypothyroidism, choose the fourth digit based on the most recent factor influencing the hypothyroidism.If the patient [...]
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