E04.2 Nontoxic multinodular goiter

ICD10CM code

#### Name of the Condition
- Nontoxic Multinodular Goiter
- ICD Code: E04.2

#### Summary
Nontoxic multinodular goiter is a condition characterized by an enlarged thyroid gland with multiple nodules. Unlike toxic goiters, it does not lead to thyroid hormone overproduction, and is typically benign.

#### Causes
The exact cause of nontoxic multinodular goiter is not well understood, but it may be associated with iodine deficiency, genetic factors, and age-related changes in the thyroid gland.

#### Risk Factors
- Age: More common in individuals over 50 years old.
- Family history: A hereditary predisposition can increase risk.
- Gender: More prevalent in women.
- Iodine deficiency: Regions with low iodine levels have higher incidences.

#### Symptoms
- Visible swelling at the base of the neck.
- Sensation of pressure on the neck, leading to difficulty swallowing or breathing.
- Generally no symptoms of hyperthyroidism, as it is "nontoxic."

#### Diagnosis
- Physical examination: Palpation of the thyroid can reveal enlargement.
- Ultrasound: Helps visualize the nodules.
- Thyroid function tests: Typically normal, distinguishing it from toxic goiters.
- Biopsy: Occasionally used to rule out cancerous growth.

#### Treatment Options
- Observation: Regular monitoring if asymptomatic.
- Thyroid hormone suppression therapy: Can help reduce goiter size.
- Surgery: Indicated if the goiter causes compressive symptoms or cosmetic concerns.

#### Prognosis and Follow-Up
- Generally good, especially if monitored regularly.
- Requires periodic evaluations to monitor growth or the development of symptoms.

#### Complications
- Compression of the trachea or esophagus.
- Cosmetic discomfort.
- Rarely, transformation into thyroid cancer.

#### Lifestyle & Prevention
- Adequate dietary iodine intake can help prevent development.
- Regular health check-ups for early detection and management.

#### When to Seek Professional Help
- Rapid growth of the goiter.
- Difficulty in swallowing or breathing.
- Sudden changes in voice or unexplained weight loss.

#### Additional Resources
- American Thyroid Association (https://www.thyroid.org)
- British Thyroid Foundation (https://www.btf-thyroid.org)

#### Tips for Medical Coders
- Ensure accurate differentiation between toxic and nontoxic goiter.
- Pay attention to clinical documentation specifying "multinodular" for precise coding.
- Common error: Misclassifying with codes related to hyperthyroidism.

Medical Policies and Guidelines for Nontoxic multinodular goiter

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