Tabular List Endocrine, Nutritional and Metabolic Diseases, and Immunity 240–244.9 Endocrine, Nutritional Metabolic and 3. Endocrine, Nutritional and Metabolic Diseases, The Endocrine System Hypothalamus and Immunity Disorders(240-279) Pituitary Pineal gland (Hypophysis) 2 endocrine and metabolic disturbances specific to the fetus gland Parathyoid and newborn (775.0-775.9) Thyroid gland glands NOTE All neoplasms, whether functionally active or not, are classified in Chapter 2. Codes in Chapter 3 (i.e., 242.8, 246.0, 251-253, Thymus gland 255-259) may be used to identify such functional activity associated with any neoplasm, or by ectopic endocrine tissue.

Adrenal Disorders of Thyroid Gland (240-246) (Suprarenal) Ovaries glands b 240 Simple and unspecified goiter Pancreas DEF: An enlarged thyroid gland often caused by an inadequate dietary intake of iodine. Testes 240.0 Goiter, specified as simple Any condition classifiable to 240.9, specified as simple § c 242.3 Toxic nodular goiter, unspecified 240.9 Goiter, unspecified [0-1] Adenomatous goiter Enlargement of thyroid

Nodular goiter toxic or with hyperthyroidism 240–244.9 Diseases, and Immunity Goiter or struma: Struma nodosa NOS diffuse colloid Any condition classifiable to 241.9 specified as toxic or with endemic hyperthyroidism hyperplastic § c 242.4 Thyrotoxicosis from ectopic thyroid nodule nontoxic (diffuse) [0-1] parenchymatous sporadic § c 242.8 Thyrotoxicosis of other specified origin 2 congenital (dyshormonogenic) goiter (246.1) [0-1] Overproduction of thyroid-stimulating hormone [TSH] Thyrotoxicosis: b 241 Nontoxic nodular goiter factitia from ingestion of excessive thyroid material 2 adenoma of thyroid (226) Use additional E code to identify cause, if drug-induced cystadenoma of thyroid (226) § c 242.9 Thyrotoxicosis without mention of goiter or other 241.0 Nontoxic uninodular goiter [0-1] cause Thyroid nodule Hyperthyroidism NOS Uninodular goiter (nontoxic) Thyrotoxicosis NOS DEF: Enlarged thyroid, commonly due to decreased thyroid E05.90 Thyrotoxicosis uns w/o thyrotoxic crisis or storm I-10 production, with single nodule; no clinical hypothyroidism. E04.1 Nontoxic single thyroid nodule I-10 243 Congenital hypothyroidism Congenital thyroid insufficiency 241.1 Nontoxic multinodular goiter Cretinism (athyrotic) (endemic) Multinodular goiter (nontoxic) DEF: Enlarged thyroid, commonly due to decreased thyroid Use additional code to identify associated mental retardation production with multiple nodules; no clinical hypothyroidism. 2 congenital (dyshormonogenic) goiter (246.1) DEF: 241.9 Unspecified nontoxic nodular goiter Underproduction of thyroid hormone present from birth. Adenomatous goiter b 244 Acquired hypothyroidism Nodular goiter (nontoxic) NOS 1 athyroidism (acquired) Struma nodosa (simplex) hypothyroidism (acquired) b 242 Thyrotoxicosis with or without goiter myxedema (adult) (juvenile) thyroid (gland) insufficiency (acquired) 2 neonatal thyrotoxicosis (775.3) DEF: A condition caused by excess quantities of thyroid hormones being 244.0 Postsurgical hypothyroidism introduced into the tissues DEF: Underproduction of thyroid hormone due to surgical removal of The following fifth-digit subclassification is for use with categories 242: all or part of the thyroid gland. 0 without mention of thyrotoxic crisis or storm E89.0 Postprocedural hypothyroidism I-10 1 with mention of thyrotoxic crisis or storm 244.1 Other postablative hypothyroidism Hypothyroidism following therapy, such as irradiation § c 242.0 Toxic diffuse goiter [0-1] Basedow's disease 244.2 Iodine hypothyroidism Exophthalmic or toxic goiter NOS Hypothyroidism resulting from administration or ingestion of Graves' disease iodide Primary thyroid hyperplasia Use additional E code to identify drug DEF: Diffuse thyroid enlargement accompanied by hyperthyroidism, bulging eyes, and dermopathy. 244.3 Other iatrogenic hypothyroidism Hypothyroidism resulting from: § c 242.1 Toxic uninodular goiter P-aminosalicylic acid [PAS] [0-1] Thyroid nodule toxic or with hyperthyroidism Phenylbutazone Uninodular goiter Resorcinol DEF: Symptomatic hyperthyroidism with a single nodule on the Iatrogenic hypothyroidism NOS enlarged thyroid gland. Abrupt onset of symptoms; including extreme nervousness, insomnia, weight loss, tremors, and psychosis Use additional E code to identify drug or coma. 244.8 Other specified acquired hypothyroidism § 242.2 Toxic multinodular goiter Secondary hypothyroidism NEC c AHA: [0-1] Secondary thyroid hyperplasia J-A, ‘85, 9 DEF: Symptomatic hyperthyroidism with multiple nodules on the 244.9 Unspecified hypothyroidism enlarged thyroid gland. Abrupt onset of symptoms; including Hypothyroidism primary or NOS extreme nervousness, insomnia, weight loss, tremors, and psychosis Myxedema or coma. AHA: 3Q, ‘99, 19; 4Q, ‘96, 29 E03.9 Hypothyroidism unspecified I-10 b c Additional Digit Required Unspecified Code Other Specified Code Manifestation Code wx Revised Text l New Code s Revised Code Title 2011 ICD-9-CM Volume 1 – 1 424–425.5 Diseases of the Tabular List

7. Diseases of the Circulatory System (390-459) 424.3 disorders Pulmonic: Pulmonic: b 424 Other diseases of incompetence NOS regurgitation NOS insufficiency NOS stenosis NOS 2 bacterial (421.0-421.9) rheumatic endocarditis (391.1, 394.0-397.9) 2 that specified as rheumatic (397.1) syphilitic endocarditis (093.20-093.24) c 424.9 Endocarditis, valve unspecified 424.0 disorders 424.90 Endocarditis, valve unspecified, unspecified Mitral (valve): cause incompetence NOS of specified cause, Endocarditis (chronic): insufficiency except rheumatic NOS regurgitation nonbacterial thrombotic 2 mitral (valve): Valvular: disease (394.9) incompetence failure (394.9) insufficiency of unspecified valve, stenosis (394.0) regurgitation unspecified cause the listed conditions: stenosis specified as rheumatic (394.1) Valvulitis (chronic) unspecified as to cause but with mention of: I38 Endocarditis valve unspecified I-10 diseases of (396.0-396.9) 424.91 Endocarditis in diseases classified elsewhere mitral stenosis or obstruction (394.2) AHA: 3Q, ’06, 7; 2Q, ‘00, 16; 3Q, ‘98, 11; N-D, ‘87, 8; N-D, ‘84, 8 Code first underlying disease as: I34.8 Other nonrheumatic mitral valve disorders I-10 atypical verrucous endocarditis [Libman-Sacks] (710.0) 424.1 Aortic valve disorders disseminated lupus erythematosus (710.0) Aortic (valve): tuberculosis (017.9) incompetence syphilitic (093.20-093.24) insufficiency NOS of specified cause, 2 regurgitation except rheumatic 424.99 Other stenosis Any condition classifiable to 424.90 with specified 2 hypertrophic subaortic stenosis (425.1) cause, except rheumatic that specified as rheumatic (395.0-395.9) 2 endocardial fibroelastosis (425.3) that of unspecified cause but with mention of diseases that specified as rheumatic (397.9) of mitral valve (396.0-396.9) b 425 AHA: 4Q, ‘08, 179; 4Q, ‘88, 8; N-D, ‘87, 8 1 myocardiopathy 424.2 disorders, specified as nonrheumatic AHA: J-A, ‘85, 15 Tricuspid valve: incompetence 425.0 Endomyocardial fibrosis insufficiency of specified cause, except 425.1 Hypertrophic obstructive cardiomyopathy regurgitation rheumatic Hypertrophic subaortic stenosis (idiopathic) stenosis DEF: Cardiomyopathy marked by left hypertrophy, enlarged 2 rheumatic or of unspecified cause (397.0) septum; results in obstructed blood flow. 425.2 Obscure cardiomyopathy of Africa Becker's disease Valve Disorders Idiopathic mural endomyocardial disease 425.3 Endocardial fibroelastosis 424–425.5System of the Circulatory Diseases Elastomyofibrosis Incompetent valve DEF: A condition marked by left ventricle hypertrophy and (trouble closing) conversion of the endocardium into a thick fibroelastic coat; capacity causes regurgitation of the ventricle may be reduced, but is often increased. Valve stenosis (backflow of blood) (trouble opening) 425.4 Other primary Cardiomyopathy: Cardiomyopathy: NOS idiopathic Insufficient valve congestive nonobstructive (unable to close completely) constrictive obstructive Shortened, fused familial restrictive chorda tendinae hypertrophic Cardiovascular collagenosis AHA: w4Q, ’09, 141;x 1Q, ‘07, 20; 2Q, ’05, 14; 1Q, ‘00, 22; 4Q, ‘97, 55; 2Q, ‘90, 19 Normal Function TIP: For congestive cardiomyopathy, assign first a code for the CHF (category 428) if the treatment is directed toward the CHF. I42.8 Other cardiomyopathies I-10 contracts Great Valve leaflet artery 425.5 (cusp) ( or DEF: Heart disease as result of excess alcohol consumption. Chorda pulmonary AHA: S-O, ‘85, 15 tendinae artery) 425.7 Nutritional and metabolic cardiomyopathy Papillary Ventricle fills Great vein muscle (vena cava or Code first underlying disease, as: pulmonary vein) amyloidosis (277.30-277.39) Atrium fills beriberi (265.0) cardiac glycogenosis (271.0) Ventricle mucopolysaccharidosis (277.5) contracts Great artery (blood to body thyrotoxicosis (242.0-242.9) or lungs) 2 gouty tophi of heart (274.82)

8 Newborn Age: 0 9 Pediatric Age: 0-17 x Maternity Age: 12-55 y Adult Age: 15-124 2 – Volume 1 2011 ICD-9-CM Tabular List Diseases of the Circulatory System 425.9–426.9 iesso h icltr ytm 425.9–426.9 Diseases of the Circulatory System 425.8 Cardiomyopathy in other diseases classified elsewhere Normal and Long QT Electrocardiogram

Code first underlying disease, as: QRS Friedreich's ataxia (334.0) Interval ST Interval Normal Long QT R Syndrome R myotonia atrophica (359.21) PR progressive muscular dystrophy (359.1) Segment QT Interval QT Interval PR ST sarcoidosis (135) Interval Segment 2 cardiomyopathy in Chagas' disease (086.0) AHA: T 2Q, ‘93, 9 P T P I43 Cardiomyopathy in diseases classified elsewhere I-10

425.9 Secondary cardiomyopathy, unspecified Q Q 426 Conduction disorders b S DEF: Disruption or disturbance in the electrical impulses that regulate S heartbeats. 0.2.4.6 0.2.4.6 426.0 , complete Third degree atrioventricular block 426.4 Right AHA: 2Q, ’06, 14 AHA: 3Q, ‘00, 3 TIP: Assign if documentation indicates intermittent complete heart I45.10 Unspecified right bundle-branch block I-10 block. c 426.1 Atrioventricular block, other and unspecified c 426.5 Bundle branch block, other and unspecified AHA: 2Q, ’06, 14 426.50 Bundle branch block, unspecified TIP: Assign separate codes for each type of AV block documented. 426.51 Right bundle branch block and left posterior 426.10 Atrioventricular block, unspecified fascicular block Atrioventricular [AV] block (incomplete) (partial) 426.52 Right bundle branch block and left anterior 426.11 First degree atrioventricular block fascicular block Incomplete atrioventricular block, first degree 426.53 Other bilateral bundle branch block Prolonged P-R interval NOS NOS AHA: 2Q, ’06, 14 Bilateral bundle branch block NOS I44.0 I-10 Atrioventricular block first degree Right bundle branch with 426.12 Mobitz (type) II atrioventricular block (incomplete) (main stem) Incomplete atrioventricular block: 426.54 Mobitz (type) II second degree, Mobitz (type) II 426.6 Other DEF: Impaired conduction of excitatory impulse from cardiac atrium to ventricle through AV node. NOS AHA: 2Q, ’06, 14 diffuse myofibrillar 426.13 Other second degree atrioventricular block Sinoatrial block Incomplete atrioventricular block: Sinoauricular block Mobitz (type) I [Wenckebach's] second degree: 426.7 Anomalous atrioventricular excitation NOS Atrioventricular conduction: Mobitz (type) I accelerated with 2:1 atrioventricular response [block] accessory Wenckebach's phenomenon pre-excitation DEF: Wenckebach’s phenomenon: impulses generated at Ventricular pre-excitation constant rate to sinus node, P-R interval lengthens; results Wolff-Parkinson-White syndrome in cycle of ventricular inadequacy and shortened P-R DEF: Wolff-Parkinson-White: normal conduction pathway is interval; second-degree A-V block commonly called bypassed; results in short P-R interval on EKG; tendency to "Mobitz type 1.” supraventricular . 426.2 Left bundle branch hemiblock c 426.8 Other specified conduction disorders Block: Block: 426.81 Lown-Ganong-Levine syndrome left anterior fascicular left posterior fascicular Syndrome of short P-R interval, normal QRS 426.3 Other left bundle branch block complexes, and supraventricular Left bundle branch block: 426.82 Long QT syndrome NOS DEF: Condition characterized by recurrent syncope, anterior fascicular with posterior fascicular malignant , and sudden death; characteristic complete prolonged Q-T interval on electrocardiogram. main stem AHA: 4Q, ’05, 72 I44.7 Left bundle-branch block unspecified I-10 426.89 Other Dissociation: Nerve Conduction of the Heart atrioventricular [AV] interference isorhythmic (pacemaker) Nonparoxysmal AV nodal tachycardia Bachmann’s bundle Internodal tracts: 426.9 Conduction disorder, unspecified Anterior Heart block NOS Middle Posterior Left bundle branch block Stokes-Adams syndrome Atrioventricular Left bundle branch: node Anterior fascicle Common bundle Posterior fascicle (of His) Left bundle branch Atrioventricular block hemiblock Accessory bundle (of Kent) Right bundle branch Right bundle branch block b c Additional Digit Required Unspecified Code Other Specified Code Manifestation Code wx Revised Text l New Code s Revised Code Title 2011 ICD-9-CM Volume 1 – 3