Google+ Followers

Saturday, July 13, 2013

IT'S NOT THYROID RELATED...BULL!

This week’s blog is short because it is my hope that you will consider taking some time to peruse the list below. This list comes from the Medicare National Coverage Determinations report. Extracted from that report is the Thyroid Testing list (below). The list indicates that thyroid function testing may be medically necessary with the following patient conditions/complaints/symptoms.
It is important to note that many major insurance companies adopt Medicare’s (The government) reimbursement coverage guidelines.
So the next time a doctor says to you “I don’t think your symptoms are “thyroid related” show them this list. I had an ER doctor tell me one time that memory loss has nothing to do with thyroid disease. It would have been great to have this list at the time…I could’ve said “Nuh Uh buddy, check out code number 780.93.”
The government assembles a team primarily of doctors to create, update, review and edit this list annually.
Here is the entire 2013 Medicare National Coverage Determinations Report - http://www.cms.gov/Medicare/Coverage/CoverageGenInfo/downloads/manual201301.pdf
THYROID TESTING LIST
Code
Description
017.50-017.56
Tuberculosis of the thyroid gland
183.0
Malignant neoplasm of ovary
193
Malignant neoplasm of thyroid gland
194.8
Malignant neoplasm of other endocrine glands and related structures
198.89
Secondary malignant neoplasm of the thyroid
220
Benign neoplasm of ovary
226
Benign neoplasm of thyroid gland
227.3
Benign neoplasm of pituitary gland and craniopharyngeal duct
234.8
Carcinoma in situ of other and unspecified sites
237.4
Neoplasm of uncertain behavior of other and unspecified endocrine glands
239.7
Neoplasm of unspecified nature, thyroid gland
240.0-240.9
Goiter specified and unspecified
241.0-241.9
Nontoxic nodular goiter
242.00-242.91
Thyrotoxicosis with or without goiter
243
Congenital hypothyroidism
244.0-244.9
Acquired hypothyroidism
245.0-245.9
Thyroiditis
246.0-246.9
Other disorders of thyroid
249.00-249.01
Secondary diabetes mellitus without mention of complication
249.10-249.11
Secondary diabetes mellitus with ketoacidosis
249.20-249.21
Secondary diabetes mellitus with hyperosmolarity
249.30-249.31
Secondary diabetes mellitus with other coma
249.40-249.41
Secondary diabetes mellitus with renal manifestations
249.50-249.51
Secondary diabetes mellitus with ophthalmic manifestations
249.60-249.61
Secondary diabetes mellitus with neurological manifestations
249.70-249.71
Secondary diabetes mellitus with peripheral circulatory disorders
249.80-249.81
Secondary diabetes mellitus with other specified manifestations
249.90-249.91
Secondary diabetes mellitus with unspecified complication
250.00-250.93
Diabetes mellitus
252.1
Hypoparathyroidism
253.1
Other and unspecified anterior pituitary hyper function
253.2
Panhypopituitarism
253.3
Pituitary dwarfism
253.4
Other anterior pituitary disorders
253.7
Iatrogenic pituitary disorders
255.2
Adrenogenital disorders
255.41
Glucocorticoid deficiency
255.42
Mineralocorticoid deficiency
256.31-256.39
Ovarian failure
257.2
Testicular hypofunction
258.0 – 258.9
Polyglandular dysfunction and related disorders
262
Malnutrition, severe
263.0-263.9
Malnutrition, other and unspecified
266.0
Ariboflavinosis
272.0
Pure hypercholesterolemia
272.2
Mixed hyperlipidemia
272.4
Other and unspecified hyperlipidemia
275.40-275.49
Calcium disorders
275.5
Hungry bone syndrome
276.0
Hyposmolality and/or hypernatremia
276.1
Hyposmolality and/or hyponatremia
278.3
Hypercarotenemia
279.41
Autoimmune lymphoproliferative syndrome
279.49
Autoimmune disease, not elsewhere classified
281.0
Pernicious anemia
281.9
Unspecified deficiency anemia
283.0
Autoimmune hemolytic anemia
285.9
Anemia, unspecified
290.0
Senile dementia, uncomplicated
290.10-290.13
Presenile dementia
290.20-290.21
Senile dementia with delusional or depressive features
290.3
Senile dementia with delirium
293.0-293.1
Delirium
293.81-293.89
Other specified transient mental disorders due to conditions classified elsewhere
294.8
Other persistent mental disorders due to conditions classified elsewhere
296.00-296.99
Episodic mood disorders
297.0
Paranoid state, simple
297.1
Delusional disorder
297.9
Unspecified paranoid state
298.3
Acute paranoid reaction
300.00-300.09
Anxiety states
307.9
Other and unspecified special symptoms or syndromes NEC
310.1
Personality change due to conditions classified elsewhere
311
Depressive disorder, NEC
327.00
Organic insomnia, unspecified
327.01
Insomnia due to medical condition classified elsewhere
327.09
Other organic insomnia
327.29
Other organic sleep apnea
327.52
Sleep related leg cramps
327.8
Other Organic sleep disorders
331.0, 331.11, 331.19, 331.2
Alzheimer’s, pick’s disease, Senile degeneration of brain
331.83
Mild cognitive impairment, so stated
333.1
Essential and other specified forms of tremor
333.99
Other extrapyramidal diseases and abnormal movement disorders
354.0
Carpal Tunnel syndrome
356.9
Idiopathic peripheral neuropathy, unspecified polyneuropathy
358.1
Myasthenic syndromes in diseases classified elsewhere
359.5
Myopathy in endocrine diseases classified elsewhere
359.9
Myopathy, unspecified
368.2
Diplopia
372.71
Conjunctival hyperemia
372.73
Conjunctival edema
374.41
Lid retraction or lag
374.82
Eyelid edema
376.21
Thyrotoxic exophthalmos
376.22
Exophthalmic ophthalmoplegia
376.30-376.31
Exophthalmic conditions, unspecified and constant
376.33-376.34
Orbital edema or congestion, intermittent exophthalmos
378.50-378.55
Paralytic strabismus
401.0-401.9
Essential hypertension
403.00-403.91
Hypertensive chronic kidney disease
404.00-404.93
Hypertensive heart and chronic kidney disease
423.9
Unspecified disease of pericardium
425.7
Nutritional and metabolic cardiomyopathy
427.0
Paroxysmal supraventricular tachycardia
427.2
Paroxysmal tachycardia, unspecified
427.31
Atrial fibrillation
427.89
Other specified cardiac dysrhythmia
427.9
Cardiac dysrhythmia, unspecified
428.0
Congestive heart failure, unspecified
428.1
Left heart failure
429.3
Cardiomegaly
511.9
Unspecified pleural effusion
518.81
Acute respiratory failure
529.8
Other specified conditions of the tongue
560.1
Paralytic ileus
564.00-564.09
Constipation
564.7
Megacolon, other than Hirschsprung’s
568.82
Peritoneal effusion (chronic)
625.3
Dysmenorrhea
626.0-626.2
Disorders of menstruation
626.4
Irregular menstrual cycle
648.10-648.14
Other current conditions in mother, classifiable elsewhere, but complicating pregnancy, childbirth, or puerperium, thyroid dysfunction
676.20-676.24
Engorgement of breast associated w/ childbirth & disorders of lactation
698.9
Unspecified pruritic disorder
701.1
Keratoderma, acquired (dry skin)
703.8
Other specified diseases of nail (Brittle nails)
704.00-704.09
Alopecia
709.01
Vitiligo
710.0-710.9
Diffuse disease of connective tissue
728.2
Muscle wasting
728.87
Muscle weakness (generalized)
728.9
Unspecified disorder of muscle, ligament, and fascia
729.1
Myalgia and myositis, unspecified
729.82
Musculoskeletal cramp
730.30-730.39
Periostitis without osteomyelitis
733.02
Idiopathic osteoporosis
733.09
Osteoporosis, drug induced
750.15
Macroglossia, congenital
759.2
Anomaly of other endocrine glands
780.01
Coma
780.02
Transient alteration of awareness
780.09
Alteration of consciousness, other
780.50
Insomnia
780.51
Insomnia with sleep apnea, unspecified
780.52
Insomnia, unspecified
780.60
Fever, unspecified
780.61
Fever presenting with conditions classified elsewhere
780.62
Postprocedural fever
780.63
Postvaccination fever
780.64
Chills (without fever)
780.65
Hypothermia not associated with low environmental temperature
780.66
Febrile nonhemolytic transfusion reaction
780.71
Chronic fatigue syndrome
780.72
Functional quadriplegia
780.79
Other malaise and fatigue
780.8
Generalized hyperhidrosis
780.93
Memory loss
780.94
Early satiety
780.96
Generalized pain
780.97
Altered mental status
780.99
Other general symptoms
781.0
Abnormal involuntary movements
781.3
Lack of coordination, ataxia
782.0
Disturbance of skin sensation
782.3
Localized edema
782.8
Changes in skin texture
782.9
Other symptoms involving skin and integumentary tissues
783.0
Anorexia
783.1
Abnormal weight gain
783.21
Abnormal loss of weight
783.6
Polyphagia
784.1
Throat pain
784.42
Dysphonia
784.43
Hypernasality
784.44
Hyponasality
784.49
Other voice and resonance disorders
784.51
Dysarthria
784.59
Other speech disturbance
785.0
Tachycardia, unspecified
785.1
Palpitations
785.9
Other symptoms involving cardiovascular system
786.09
Other symptoms involving respiratory system
786.1
Stridor
787.20
Dysphagia, unspecified
787.21
Dysphagia, oral phase
787.22
Dysphagia, oropharyngeal phase
787.23
Dysphagia, pharyngeal phase
787.24
Dysphagia, pharyngo-esophageal phase
787.29
Other dysphagia
787.91-787.99
Other symptoms involving digestive system
789.51
Malignant Ascites
789.59
Other Ascites
793.99
Other nonspecific (abnormal) findings on radiological and other examination of body structure
794.5
Thyroid, abnormal scan or uptake
796.1
Other nonspecific abnormal findings, abnormal reflex
799.21
Nervousness
799.22
Irritability
799.23
Impulsiveness
799.24
Emotional lability
799.25
Demoralization and apathy
799.29
Other signs and symptoms involving emotional state
990
Effects of radiation, unspecified
V10.87
Personal history of malignant neoplasm of the thyroid
V10.88
Personal history of malignant neoplasm of other endocrine gland
V10.91
Personal history of malignant neuroendocrine tumor
V12.21
Personal history of gestational diabetes
V12.29
Personal history of other endocrine, metabolic, and immunity disorders

V58.69
Long term (current) use of other medications




Don't forget to get your copy of my thyroid book, Wow Your Mom Really is Crazy. Buy it on Amazon today.

15 comments:

  1. In this long list of conditions that are currently taken to be grounds for thyroid testing (those items that aren't obviously thyroid conditions, that is: those conditions would presumably be identified by thyroid testing, rather than being grounds for undertaking it), many have a range of potential causes, many of which are more common causes than thyroid dysfunction, e.g. the thyroid is not listed as a common cause of 'Malignant neoplasm of ovary'. Loss of memory is well known to have a number of possible causes. So if 'a doctor says to you 'I don’t think your symptoms are “thyroid related”', their reasons for saying so might be that there is a more likely cause or causes in your case, not necessarily because they do not know that SEVERE hypothyroidism can be a cause of memory loss. Certainly if your doctor declared that there is no connection between the conditions he was wrong, but he might not have been wrong if he'd told you that he didn't think it was the cause in your case. The list of conditions is striking, but without any accompanying list of the percentage of known cases in which thyroid disfunction has figured as a cause for each condition, it is not, on its own, a useful guide, still less an authoritative source for challenges to or discussions with your GP.

    ReplyDelete
    Replies
    1. Hi Kevin,
      This list shows that these conditions COULD be thyroid related. I am not saying that each person who has these symptoms also has a thyroid condition, that is not realistic. I think the point to be made here is that MD’s should NEVER tell a thyroid sufferer that if their hair is falling out or if they have memory loss, etc…that it is unequivocally not thyroid related. Unless they can back that up with 100% proof of what is REALLY causing the issue. That ER doctor knew I had a thyroid condition and he told me that my memory loss was not thyroid related, but did not offer me any other suggestions of what it could be… these responses from doctors are typical.

      And if I may ask, if there was a percentage offered for each item on this list…what exactly would that do to validate this list?

      Delete
    2. This is where I meant to place this....Well....considering this list...it seems like a reasonable idea to perform the blookwork neccessary to eliminate thyroid disease as a possible cause. Some of the tests I was put through were way more extensive and expensive...and of course they turned up nothing....if someone had just tested my thyroid they would not have needed to waste my time and money with neurologists, gastroenterologists,dermatologists and cardiologists. Even just a simple TSH test, while not the best, would have pointed me in the right direction and saved me years of misery.....BTW....not one of the 5 endocrinologists I have seen was even interested in considering my symptoms of brain fog, the strange skin rashes and my digestive issues as thyroid related....that fact does not reassure me that a GP is any more qualified to comment on how the conditions on the list may or may not be thyroid related.

      Delete
    3. my doctor told me just this week, that thyroid effects every cell in the body, therefore can be the cause of symptom or disease.

      Delete
  2. This is a great list.,I book mark it to keep.

    ReplyDelete
  3. Well....considering this list...it seems like a reasonable idea to perform the blookwork neccessary to eliminate thyroid disease as a possible cause. Some of the tests I was put through were way more extensive and expensive...and of course they turned up nothing....if someone had just tested my thyroid they would not have needed to waste my time and money with neurologists, gastroenterologists,dermatologists and cardiologists. Even just a simple TSH test, while not the best, would have pointed me in the right direction and saved me years of misery.....BTW....not one of the 5 endocrinologists I have seen was even interested in considering my symptoms of brain fog, the strange skin rashes and my digestive issues as thyroid related....that fact does not reassure me that a GP is any more qualified to comment on how the conditions on the list may or may not be thyroid related.

    ReplyDelete
  4. I have a majority of these symptoms with my hypothyroidism.

    ReplyDelete
  5. Thank you so much. I've heard that remark about "it's not your thyroid" over and over and have tried to convince my endo that there is much to learn. He does agree with that one. But in the meantime, it does not help me or you one bit.

    ReplyDelete
  6. Fantastic information as always Carol. It never ceases to amaze me how little front line healthcare providers know about all things "thyroid". Yet their ego/arrogance prevents them from admitting they do not know everything.
    I hope you are well, take care, Robert.

    ReplyDelete
  7. Thank you for posting this. I've saved all the pages from the original site in my arsenal should I need it.

    ReplyDelete
  8. My endocrinologist told me that the nightly severe leg cramps I was having for hours on end every night had nothing to do with my thyroid. He suggested I was dehydrated. When I told him I keep a 24 oz tumbler at my desk and drink no less than 5 per day of water while at work plus I drink water at home, still said it was just dehydration. Then he increased my meds based off of my blood work and magically the cramps went away....yeah nothing to do with it.

    ReplyDelete
  9. Thank you so much for the wonderful information.This is really important for me.I am searching this kind of information from a long time and finally got it.

    ReplyDelete
  10. Your website is terribly informative and your articles are wonderful.

    Renal test online

    ReplyDelete
  11. To get more info on laser hair removal, you can click here. You might also want to learn more about laser hair removal gurgaon.

    ReplyDelete
  12. Thanks for the brilliant info. I wish our Drs were so informative.

    ReplyDelete