Understanding ICD-10 Codes for Graves Disease: A Complete Guide

ICD-10 codes for Graves disease are essential for healthcare providers, medical billers, and patients navigating the healthcare system. The primary code used for Graves disease is E05.00, which specifically identifies thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm. This code became effective October 1, 2025, as part of the 2026 ICD-10 coding edition.

What Is Graves Disease?

Graves disease is an autoimmune condition where your immune system attacks your thyroid gland. This attack causes the thyroid to produce too much hormone, leading to hyperthyroidism.

The thyroid is a small, butterfly-shaped gland in your neck. When it works too hard, your entire body speeds up. Your heart races, you lose weight without trying, and you feel nervous or anxious.

About 3% of Americans have this condition. Women get it 7 to 8 times more often than men.

ICD-10 Codes for Graves Disease: The Main Code

The primary ICD 10 code for Graves disease is E05.00. This is a billable code, meaning healthcare providers can use it for insurance claims and reimbursement.

Code Breakdown

E05.00 falls under a specific hierarchy:

1. E00-E89: Endocrine, nutritional and metabolic diseases
2. E05: Thyrotoxicosis (hyperthyroidism)
3. E05.0: Thyrotoxicosis with diffuse goiter

The code E05.00 specifically indicates that you have Graves disease without a thyrotoxic crisis or storm, which is a life-threatening complication.

Related ICD-10 Codes You Should Know

E05.01 – Graves Disease with Crisis

This code applies when someone experiences a thyrotoxic storm. This is a severe, life-threatening complication requiring immediate medical attention.

E05.90 – Unspecified Thyrotoxicosis

Healthcare providers use this code when they diagnose hyperthyroidism but haven’t determined the specific cause yet.

E05.0 – Parent Code

This is a non-billable parent code. Providers must use a more specific code like E05.00 or E05.01 for billing purposes.

Recognizing Graves Disease Symptoms

Understanding the symptoms helps explain why accurate coding matters for treatment and billing.

Physical Symptoms

Your body shows clear signs when your thyroid works overtime:

1. Rapid or irregular heartbeat
2. Unexplained weight loss despite eating normally
3. Constant sweating and heat intolerance
4. Trembling hands
5. Thin, warm, moist skin
6. Frequent bowel movements

Eye-Related Issues

About 1 in 3 people with Graves disease develop thyroid eye disease. This causes:

1. Bulging eyes (exophthalmos)
2. Double vision
3. Eye pain and pressure
4. Light sensitivity
5. Eye irritation

Half of all Graves disease patients experience some eye troubles. About 10% face serious issues requiring specialist care.

Other Warning Signs

Watch for these additional symptoms:

1. Difficulty sleeping
2. Constant fatigue despite feeling “wired”
3. Anxiety and nervousness
4. Hair loss
5. Visible goiter (enlarged thyroid in your neck)
6. Changes in menstrual periods
7. Thickened skin on your legs

Why Accurate Coding Matters

For Healthcare Providers

Using the correct ICD 10 codes for Graves disease ensures proper:

1. Insurance claim submission
2. Reimbursement from payers
3. Medical record documentation
4. Treatment tracking
5. Quality reporting

For Patients

Accurate coding affects your:

1. Insurance coverage
2. Out-of-pocket costs
3. Access to appropriate treatments
4. Medical history documentation

For Medical Billers

Proper coding reduces:

1. Claim denials
2. Account receivables delays
3. Revenue cycle disruptions
4. Administrative burden

DRG Groups for Graves Disease

When hospitals treat Graves disease, they use MS-DRG codes for billing. The relevant groups include:

Endocrine Disorder DRGs:

1. 643: Endocrine disorders with major complications
2. 644: Endocrine disorders with complications
3. 645: Endocrine disorders without complications

Surgical DRGs (for severe cases requiring tracheostomy):

1. 011-013: Various tracheostomy procedures

What Causes Graves Disease?

Genetic Factors

About 80% of your risk comes from genetics. If family members have thyroid problems, your risk increases.

Environmental Triggers

Several factors can trigger Graves disease in people with genetic predisposition:

1. High stress levels
2. Pregnancy or postpartum period
3. Viral infections
4. Smoking
5. Certain medications
6. Radiation exposure to the neck

Treatment Options for Graves Disease

Medications

Anti-thyroid drugs slow down hormone production. These help control symptoms within weeks.

Radioactive Iodine

This treatment destroys overactive thyroid cells. Most patients need only one dose.

Surgery

Doctors rarely recommend surgery. It’s reserved for people who can’t tolerate other treatments or have very large goiters.

Ongoing Monitoring

All treatments require regular follow-up with an endocrinologist to ensure proper thyroid hormone levels.

Complications to Watch For

Untreated Graves disease can cause serious problems:

1. Heart disease and irregular heartbeat
2. Weak bones (osteoporosis)
3. Mental health deterioration
4. Fertility issues
5. Pregnancy complications
6. Thyroid storm (life-threatening emergency)

Documentation Requirements for Coding

Healthcare providers must document specific details to support code E05.00:

1. Presence of diffuse goiter
2. Laboratory results showing hyperthyroidism
3. Absence of thyrotoxic crisis
4. Related symptoms (eye problems, skin changes, etc.)
5. Treatment plan

Poor documentation leads to coding errors, claim denials, and payment delays.

Alternative Names for Graves Disease

Medical records might use different terms for the same condition:

1. Toxic diffuse goiter
2. Basedow’s disease
3. Parry disease
4. Exophthalmic goiter
5. Autoimmune hyperthyroidism
6. Graves-Basedow disease

All these terms should be coded as E05.00 when there’s no thyrotoxic crisis.

Tips for Accurate Medical Billing

For Healthcare Providers

1. Document all symptoms thoroughly
2. Note the presence or absence of complications
3. Record examination findings clearly
4. Include relevant lab results
5. Specify treatment plans

For Medical Coders

1. Review complete medical records
2. Verify the absence of thyrotoxic crisis
3. Check for related conditions requiring additional codes
4. Ensure code specificity matches documentation
5. Stay updated on annual ICD-10 changes

For Patients

1. Keep copies of your medical records
2. Understand your diagnosis
3. Ask questions about coding on bills
4. Review explanation of benefits statements
5. Report billing errors promptly

Living with Graves Disease

Managing this condition requires ongoing care:

1. Regular blood tests to monitor hormone levels
2. Consistent medication adherence
3. Stress management
4. Adequate sleep
5. Avoiding smoking
6. Regular follow-up appointments

Most people with Graves disease live normal, healthy lives with proper treatment.

When to See a Doctor Immediately

Seek emergency care if you experience:

1. Extreme rapid heartbeat
2. High fever
3. Severe confusion or agitation
4. Extreme weakness
5. Loss of consciousness

These symptoms might indicate a thyrotoxic storm, which requires code E05.01 and immediate medical intervention.

FAQs

Conclusion

Understanding ICD-10 codes for Graves disease helps everyone involved in healthcare. Code E05.00 accurately identifies thyrotoxicosis with diffuse goiter without crisis. Proper coding ensures appropriate treatment, fair reimbursement, and accurate medical records.

If you have Graves disease, work closely with your healthcare team. With proper treatment and monitoring, you can manage symptoms effectively and maintain good quality of life.

Remember, accurate medical coding isn’t just about numbers. It’s about ensuring you receive the right care at the right time while keeping the healthcare system running smoothly.