Friday, September 23, 2016

CPT 76536, 76641, 76642, 77067, 77059, 76498 - Ultrasound chest, breast , head and neck

 Procedure Code and description

76536 - Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation - Average fee amount - $110 - $120

76604 - Ultrasound, chest (includes mediastinum), real time with image documentation

76641 - Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete average fee amount - $100 - $120

76498 Unlisted magnetic resonance procedure (e.g., diagnostic, interventional)

76499 Unlisted diagnostic radiographic procedure

76641  Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete

76642  Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; limited

77058  Magnetic resonance imaging, breast, without and/or with contrast material(s); unilateral

77059 Magnetic resonance imaging, breast, without and/or with contrast material(s); bilateral

77065 Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral

77066 Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral

77067 Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed


Coverage Indications, Limitations, and/or Medical Necessity

    Ultrasound of the head and neck will be considered medically reasonable and necessary when used for the following indications:

    · Evaluation of abnormalities in the tissues and/or organs of the head and neck (i.e., palpable masses)

    · Evaluation of abnormalities detected on other imaging examinations (i.e., areas of abnormal uptake seen on radioisotope thyroid examinations)

    · Personal or family history of thyroid malignancies

    · Evaluation of suspected regional nodal metastases in patients with a proven thyroid carcinoma

    · Follow-up of lesion/nodule (i.e., after medical suppression therapy)

    · Localization of thyroid/parathyroid glands or cervical lymph nodes for biopsy, ablation, or other interventional procedures

  Dysphagia/swallowing therapy is a medically prescribed treatment concerned with improving or restoring functions which have been impaired by illness or injury. Phases of swallowing addressed include oral, pharyngeal, and/or esophageal (upper one third) phases of swallowing.

    Dysphagia is a swallow disorder that may be due to various neurological, structural, and cognitive deficits. Dysphagia may be the result of head trauma, cerebrovascular accident, neuromuscular degenerative diseases, head and neck cancer, and encephalopathies. While dysphagia can afflict any age group, it most often appears among the elderly.

    The diagnosis of dysphagia, or difficulties in swallowing, requires an extensive evaluation by the physician. Many difficulties can be identified and treated based on the findings of this examination alone. In some cases, more extensive evaluations are required using a variety of studies such as echography and modified barium swallow studies and an evaluation by a swallowing therapist.

    The treatment of dysphagia/swallowing difficulties may include simple recommendations for such things as intake consistency or positioning, or may require a therapeutic regime targeted at the attainment of functional improvement.

    Patients who are motivated, moderately alert, and have some degree of deglutition and swallowing functions are appropriate candidates for dysphagia therapy. Elements of the therapy program can include thermal stimulation to heighten the sensitivity of the swallowing reflex, exercises to improve oral-motor control, training in laryngeal adduction and compensatory swallowing techniques, and positioning and dietary modifications. Design all programs to ensure swallowing safety of the patient during oral feedings and maintain adequate nutrition.

    Speech-language pathology services are covered under Medicare for the treatment of dysphagia, regardless of the presence of a communication disability.

    Dysphagia/swallowing therapy is medically necessary when the following conditions are met:


    · The patient must be under the care of a physician. The attending physician may be the patient’s private physician or a physician associated with an institution. Collaboration between the physician and the speech language pathologist or other dysphagia therapist is necessary to establish the medical necessity for the dysphagia evaluation and/or treatment.

    · The therapy must be furnished under the written plan of treatment, with measurable goals and time frames established by the physician or therapist caring for the patient. The services must be of such a level of complexity and sophistication that they can only be performed by a qualified dysphagia therapist.

    · The physician must establish a preliminary diagnosis addressing the symptoms associated with the dysphagia. This preliminary diagnosis should address the treatability of the patient in terms of the patient’s:

        level of alertness

        ability to cooperate

        ability to retain new learning

        cognitive status

        medical stability

        psychological stability


    · There must be a recent significant change in swallowing function for a dysphagia evaluation to be medically necessary. One or more of the following conditions must be present:

        History of aspiration problems or definite risk of aspiration.

        Impaired salivary gland performance and/or presence of local structural lesions in the pharynx in marked oropharyngeal swallowing difficulties.

        Dyscoordination, sensation loss, postural difficulties, or other neuromotor disturbances affecting oropharyngeal abilities necessary to close the buccal cavity and/or bite, chew, suck, shape, and squeeze the food bolus into the upper esophagus, while protecting the airway.

        Post surgical reaction.

        Significant weight loss directly related to reduced oral intake as a consequence of dysphagia.

        Existence of other conditions such as: presence of tracheotomy tube, nasogastric feeding tube, endotracheal tube, or ventilator reduced or inadequate laryngeal elevation, labial closure, velopharyngeal closure, laryngeal closure, or pharyngeal peristalsis and cricopharyngeal disjunction.


    Videofluroscopy or other visual instrumental assessments should be conducted when oral or pharyngeal disorders are suspected. Documentation must establish that an exact diagnosis cannot be substantiated through oral exam and that there is a question as to whether aspiration is occurring. The videofluoroscopic assessment is usually conducted and interpreted by a radiologist with the assistance and input from the physician and/or individual disciplines. The assessment and final analysis and interpretation should include a definitive diagnosis, identification of the swallowing phase(s) affected, and a recommended treatment plan.

Revenue Codes

    Code Description

    0320 Radiology - Diagnostic - General Classification
    0321 Radiology - Diagnostic - Angiocardiography
    0322 Radiology - Diagnostic - Arthrography
    0323 Radiology - Diagnostic - Arteriography
    0324 Radiology - Diagnostic - Chest X-Ray
    0329 Radiology - Diagnostic - Other Radiology - Diagnostic


AACE appreciates the opportunity to comment on the Centers for Medicare and Medicaid Services (CMS)  proposed rule and revisions to Medicare Part B payment policies under the Medicare Physician Fee Schedule (MPFS) for Calendar Year 2016, published in the Federal Register on July 15, 2015.

Our comments pertain to the following issues:

1. Identification of Procedure™ Code 76536 as a Potentially Misvalued Code

2. Improved Payment for the Professional Work of Care Management Services

3. Establishing Separate Payment for Collaborative Care

4. CCM and TCM Services

5. Target for Relative Value Adjustments for Misvalued Services

6. Phase-In for Significant RVU Reductions

7. Clinical Improvement Activities under MIPS

8. Physician Compare


1. Identification of Procedure Code 76536 as a Potentially Misvalued Code

Proposed Rule: CMS has included Procedure™ code 76536, ultrasound exam of head and neck, in a list of potentially misvalued codes identified through the high expenditure by specialty screen.

Procedure™ code 76536 was surveyed in April 2009 and proposed interim relative value units (RVUs) were included in the Medicare Physician Fee Schedule final rule for CY2010. CMS published final RVUs for Procedure™ code 76536 in the 2011 Medicare Physician Fee Schedule final rule. AACE maintains that these actions constitute review of Procedure™ code 76536 within the last five years and therefore Procedure™ code 76536 does not fit the criteria for the misvalued code list and should be removed.

Payment Information

The following chart provides payment information that is based on the national unadjusted Medicare physician fee schedule for the ultrasound services discussed in this guide. Payment will vary by geographic region. Use the "Professional Payment" column to estimate reimbursement to the physician for services provided in facility settings.

Ambulatory Payment Classification (APC) codes and payments are used by Medicare to reimburse facilities under the Hospital Outpatient Prospective Payment System (OPPS). Payment is based on the national unadjusted OPPS amounts for facilities. The actual payment will vary by location.



Procedure Code       Procedure Code Descriptor   Global Payment   Professional Payment   Technical Payment   APC Code   APC Payment 


76536  Ultrasound, soft tissues of head and neck (e.g. thyroid, parathyroid, parotid), real time with image documentation

$123.59

$28.66

$94.93

0266

$134.57

Neck masses that are located on the anterior neck should have ultrasound (Procedure ®76536) performed as the initial imaging study.

For possible neck masses or fullness of the neck that is not well described on physical examination, ultrasound (Procedure ®76536) or ENT evaluation can be helpful in making decisions regarding the need for advanced imaging.

Ultrasound (Procedure ®76536) and nuclear medicine thyroid scan are the preferred initial imaging studies for suspected thyroid masses. If ultrasound shows a dominant mass, fine needle aspiration (FNA) should be the next diagnostic study.


Benign thyroid nodules should have a follow-up ultrasound (Procedure ®76536) 6 to 18 months after the initial FNA.

* If nodule size is stable, follow-up ultrasound exam (Procedure ®76536) can be performed every 3 to 5 years.


Incidental thyroid nodules found on imaging (ultrasound, CT, or MRI) can be followed by ultrasound (Procedure ®76536). FNA is indicated if there is concern for malignancy.


 Patients with a suspected substernal goiter (i.e. a major portion of the goiter lies within the mediastinum) should have a neck ultrasound (Procedure ®76536) or radionuclide study first to confirm extension of the thyroid to the sternum.


Reimbursement Rate Changes and Updates for Radiology Procedure Codes 76641 and 76642



Note: This article applies to claims submitted to TMHP for processing. For claims processed by a Medicaid managed care organization (MCO), providers must refer to the MCO for information about benefits, limitations, prior authorization, and reimbursement.

Effective June 12, 2015, for dates of services on or after January 1, 2015, the following reimbursement rate changes and updates for radiology procedure codes 76641 and 76642 were approved at the May 14, 2015, public rate hearing:

TOS* Procedure Code Age Range Non-Facility (N)/Facility (F) Medicaid RVU Effective 1/1/2015 Medicaid Conversion Factor Effective 1/1/2015 Medicaid Fee Effective 1/1/2015

4 76641 0-20 N/F 3.06 $28.0672 $85.89
4 76641 21-999 N/F 3.06 $26.7305 $81.80


Oxford has engaged eviCore Healthcare to perform initial reviews of requests for pre-certification and medical necessity reviews for CPT/HCPCS codes 0159T, 76377, 76499, 77058, 77059 and S8080 (Oxford continues to be responsible for decisions to limit or deny coverage and for appeals). 2Precertification is not required through eviCore Healthcare or Oxford for CPT/HCPCS codes 76641, 76642, 77051, 77052, 77055-77057, G0202, G0204, G0206 or G0279. 3Precertification is required for services covered under the Member's General Benefits package when performed in the office of a participating provider. For Commercial plans, precertification is not required, but is encouraged for out-ofnetwork services performed in the office that are covered under the Member's General Benefits package. If precertification is not obtained, Oxford may review for medical necessity after the service is rendered.


76641 - Ultrasound, breast, unilateral, real time with image documentation, including axilla when performed; complete.

For a bilateral breast ultrasound, a modifier 50 should be added to either 76641 or 76642 to indicate a bilateral procedure. The 2015 Medicare Physician Fee Schedule assigns a “1” bilateral indicator to both CPT codes 76641 and 76642 which means that Medicare will allow 150 percent of the standard reimbursement rate. There should not be two CPT codes billed if a bilateral ultrasound exam is needed.

BENEFIT CONSIDERATIONS FOR oxford 

Coverage must be provided for an ultrasound evaluation, a magnetic resonance imaging (MRI) scan, or other additional testing of an entire breast or breasts, after a baseline mammogram exam if the:

** Mammogram demonstrates extremely dense breast tissue,

** Mammogram is abnormal within any degree of breast density including:

o Not dense

o Moderately dense

o Heterogeneously dense or

o Extremely dense breast tissue

** Patient has additional risk factors for breast cancer including, but not limited to:

o Family history of breast cancer

o Prior personal history of breast cancer

o Positive genetic testing

o Extremely dense breast tissue based on the Breast Imaging Reporting and Data System established by the

American College of Radiology or

o Other indications as determined the patient's health care provider

Coverage of the above services (ultrasound, MRI, etc.) will be provided under a Member’s:


** Preventive benefit when it the service is performed as a result of any of the above indications.

** General benefit package when the service is performed as a result of any indication other than those listed above (i.e., Lump or mass in breast, etc.). Diagnostic services are may be subject cost share (i.e., co-payment and/or co-insurance). Please refer to the Member specific benefit plan document for details regarding benefit coverage.

For additional information on baseline mammogram services, refer to the policy titled Preventive Care Services.

COVERAGE RATIONALE

Important Note: Oxford has engaged eviCore healthcare to perform initial reviews of requests for precertification and medical necessity reviews for CPT/HCPCS codes 0159T, 76377, 76499, 77058, 77059, and S8080. (Oxford continues to be responsible for decisions to limit or deny coverage and for appeals.)

To pre-certify a radiology procedure, please call eviCore healthcare at 1-877-PRE-AUTH (1-877-773-2884) or log onto the eviCare healthcare web page at www.evicore.com.

eviCore has established an infrastructure to support the review, development, and implementation of comprehensive outpatient imaging criteria. The radiology evidence-based guidelines and management criteria are available on the eviCore healthcare website: www.evicore.com.

Please refer to the policy titled Radiology Procedures Requiring Precertification for eviCore healthcare Arrangement for applicable CPT/HCPCS codes and additional requirements, if applicable.

Breast Imaging as an Adjunct to Mammography Digital mammography is proven and medically necessary for patients with dense breast tissue.

Breast Magnetic Resonance Imaging (MRI)

Breast magnetic resonance imaging (MRI) is proven and medically necessary for patients at high risk for breast cancer as defined as having any of the following:

** Personal history of atypical breast histologies

** Family history or genetic predisposition for breast cancer

** Prior therapeutic thoracic radiation therapy

** Dense breast tissue with any one of the following risk factors:

o Lifetime risk of breast cancer of =20%, according to risk assessment tools based on family history

o Personal history of BRCA1 or BRCA 2 gene mutations

o First-degree relative with a BRCA 1 or BRCA 2 gene mutation but no having had genetic testing themselves

o Prior therapeutic thoracic radiation therapy between ages of 10-30

o Personal history of Li Fraumeni Syndrome, Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome or a first-degree relative with one of these syndromes.

Breast magnetic resonance imaging (MRI) is unproven and not medically necessary for patients with dense breast tissue not accompanied by defined risk factors as described above.

Magnetic Resonance Elastography of the Breast Magnetic resonance elastography (MRE) is unproven and not medically necessary for breast cancer screening or diagnosis.


There is insufficient evidence to conclude that MRE of the breast is effective for the screening or diagnosis of breast cancer. While data from small feasibility studies indicate that MRE may have some ability to discriminate between cancerous tissue and normal breast tissue or benign lesions based on tissue stiffness, there was overlap in values, and the diagnostic accuracy of MRE for detection of breast cancer remains to be determined. There are no definitive patient selection criteria for MRE for breast cancer detection.

Breast Specific Gamma Imaging (Scintimammography)

Scintimammography is unproven and not medically necessary for breast cancer screening or diagnosis. There is insufficient evidence that this diagnostic modality can differentiate benign from malignant breast lesions. Based on the evidence, the role of scintimammography remains unclear since this technology has not been shown to be accurate enough to screen for breast cancer or allow a confident decision to defer biopsy.


Electrical Impedance Scanning (EIS)

Electrical impedance scanning (EIS) is unproven and not medically necessary for the detection of breast cancer.

There is insufficient evidence that EIS is effective in detecting malignant breast tissue. Evaluation of sensitivity and negative predictive value for EIS is inconsistent. Well-designed studies are needed to determine whether or not EIS is effective as an adjunct to mammography or provides a positive clinical benefit.

Computer Aided Detection for MRI of the Breast

Computer-aided detection (CAD) is unproven and not medically necessary as an aid for radiologists to interpret contrast-enhanced magnetic resonance imaging (MRI) of the breast. Clinical evidence has not yet demonstrated that CAD improves patient outcomes or reduces breast cancer mortality  when added to contrast-enhanced MRI. There is insufficient evidence to assess whether the use of CAD systems would maintain or increase the sensitivity, specificity, and recall rates of MRI of the breast. Prospective, well-designed and executed studies are needed to determine whether or not the use of CAD provides a positive clinical benefit.

Breast Ultrasound

Breast ultrasound is unproven and not medically necessary for routine breast cancer screening including patients with dense breast tissue.

Clinical evidence has not yet demonstrated that routine use of ultrasonography as an adjunct to screening mammography reduces the mortality rate from breast cancer.

Breast ultrasound is proven and medically necessary as an aid for radiologists to localize breast lesions and in guiding placement of instruments for cyst aspiration and percutaneous breast biopsies.

Computer-Aided Detection for Ultrasound Computer-aided detection (CAD) is unproven and not medically necessary as an aid for radiologists to detect breast cancer during ultrasound.

Clinical evidence has not yet demonstrated that CAD improves patient outcomes or reduces breast cancer mortality when added to ultrasonography. Future research should include better-designed studies, including prospective studies and randomized controlled trials evaluating this technology in large numbers of screening ultrasounds. Computer-Aided Tactile Breast Imaging Computer-aided tactile breast imaging is unproven and not medically necessary. Clinical evidence is insufficient to determine whether tactile breast imaging improves outcomes for the screening or diagnosis of breast cancer. Future research should include better-designed studies, including comparative, prospective and randomized controlled trials evaluating this  technology.




Automated Breast Ultrasound

Automated breast ultrasound is unproven and not medically necessary.

Clinical evidence is insufficient to determine whether automated breast ultrasound improves the detection rate of breast cancer compared to screening mammography. Future research should include better-designed studies, including prospective studies and randomized controlled trials evaluating this technology.

Refer to the eviCore healthcare Evidence Based Imaging Guidelines - Oxford for:

** Magnetic resonance imaging (MRI) of the breast

** 3D rendering of computed tomography, magnetic resonance imaging or other tomographic modalities


Chest Ultrasound Coding Notes

* Chest ultrasound: CPT®76604
* Breast ultrasound
o CPT®76641: unilateral, complete
o CPT®76642: unilateral, limited
o CPT®76641 and CPT®76642 should be reported only once per breast, per imaging session
* Axillary ultrasound: CPT®76882 (unilateral); if bilateral can be reported as CPT®76882 x 2


 Breast Ultrasound

* Routine performance of breast ultrasound as stand-alone screening or with screening mammography is inappropriate.
o Do NOT use breast ultrasound to screen general population as either a stand-alone study or a combined study with screening mammography.
* Breast ultrasound (CPT 76641: unilateral, complete OR CPT 76642: unilateral, limited) can be used to further evaluate abnormalities found on mammogram, especially in differentiating cysts from solid lesions.
o Bilateral should be coded CPT 76641 x 2 OR CPT 76642 x 2
* Palpable breast masses should be evaluated with mammography and breast ultrasound, in any order, regardless of age. Ultrasound can enhance biopsy.
* Axilla ultrasound (CPT®76882)
o For women with clinically suspicious lymph nodes, preoperative axillary ultrasound with a FNA or biopsy can help identify individuals who have positive nodes.
o Bilateral should be coded CPT®76882 x 2

Breast MRI Indications

* Low risk, probably benign (BI-RADS™ 3) lesions
o Repeat the original type study (mammogram, US or MRI) in 6 months, thereafter, screening or surveillance does not require MRI
* Suspicious (BI-RADS™ 4 or 5) lesion on mammogram and/or ultrasound
o Bilateral total breast ultrasound (CPT®76641: unilateral, complete), and bilateral axillary ultrasound (CPT®76882) are recommended for individuals who have BI-RADSTM 4 or 5 abnormalities. If additional suspicious breast lesions or more extensive malignant breast disease is detected by ultrasound, the extent of disease can be mapped with ultrasound-guided biopsies (CPT®76942).
o A lesion categorized as have BI-RADSTM 4 or 5 should be biopsied.
o A palpable lesion should be considered for biopsy.

Nipple Discharge/Galactorrhea

* Mammogram should be obtained and ultrasound (CPT®76641: unilateral, complete or CPT®76642: unilateral, limited) as initial imaging:
o If mammogram and ultrasound are negative, a ductal excision is indicated. A ductogram may be useful to exclude multiple lesions and to localize lesions before surgery.
o Ductal excision is indicated even if the ductogram is negative.
o An MRI may be considered if a ductogram is technically limited
o For a Birads 4 or 5 based on mammogram and/or ultrasound, biopsy is indicated


Breast Pain (Mystodynia)

* Mammogram and ultrasound are the initial imaging for breast pain
* Advanced imaging is NOT routinely indicated in individuals with breast pain and negative evaluation (evaluation includes individual history and physical exam, pregnancy test, mammogram and ultrasound (CPT®76641: unilateral, complete or CPT®76642: unilateral, limited).

o If evaluation is not negative, see CH-25.5 Breast MRI Indications


ICD CODE for Procedure 76536


C47.0Malignant neoplasm of peripheral nerves of head, face and neck
C49.0Malignant neoplasm of connective and soft tissue of head, face and neck
C73Malignant neoplasm of thyroid gland
C74.00Malignant neoplasm of cortex of unspecified adrenal gland
C74.01Malignant neoplasm of cortex of right adrenal gland
C74.02Malignant neoplasm of cortex of left adrenal gland
C74.10Malignant neoplasm of medulla of unspecified adrenal gland
C74.11Malignant neoplasm of medulla of right adrenal gland
C74.12Malignant neoplasm of medulla of left adrenal gland
C74.90Malignant neoplasm of unspecified part of unspecified adrenal gland
C74.91Malignant neoplasm of unspecified part of right adrenal gland
C74.92Malignant neoplasm of unspecified part of left adrenal gland
C75.0Malignant neoplasm of parathyroid gland
C75.4Malignant neoplasm of carotid body
C76.0Malignant neoplasm of head, face and neck
C77.0Secondary and unspecified malignant neoplasm of lymph nodes of head, face and neck
C83.11Mantle cell lymphoma, lymph nodes of head, face, and neck
C83.31Diffuse large B-cell lymphoma, lymph nodes of head, face, and neck
C83.51Lymphoblastic (diffuse) lymphoma, lymph nodes of head, face, and neck
C83.81Other non-follicular lymphoma, lymph nodes of head, face, and neck
C84.41Peripheral T-cell lymphoma, not classified, lymph nodes of head, face, and neck
C84.61Anaplastic large cell lymphoma, ALK-positive, lymph nodes of head, face, and neck
C84.71Anaplastic large cell lymphoma, ALK-negative, lymph nodes of head, face, and neck
C85.21Mediastinal (thymic) large B-cell lymphoma, lymph nodes of head, face, and neck
D09.3Carcinoma in situ of thyroid and other endocrine glands
D09.8Carcinoma in situ of other specified sites
D21.0Benign neoplasm of connective and other soft tissue of head, face and neck
D34Benign neoplasm of thyroid gland
D35.1Benign neoplasm of parathyroid gland
D49.7Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system
E01.0Iodine-deficiency related diffuse (endemic) goiter
E01.1Iodine-deficiency related multinodular (endemic) goiter
E01.2Iodine-deficiency related (endemic) goiter, unspecified
E03.4Atrophy of thyroid (acquired)
E04.0Nontoxic diffuse goiter
E04.1Nontoxic single thyroid nodule
E04.2Nontoxic multinodular goiter
E04.8Other specified nontoxic goiter
E04.9Nontoxic goiter, unspecified
E05.00Thyrotoxicosis with diffuse goiter without thyrotoxic crisis or storm
E05.01Thyrotoxicosis with diffuse goiter with thyrotoxic crisis or storm
E05.10Thyrotoxicosis with toxic single thyroid nodule without thyrotoxic crisis or storm
E05.11Thyrotoxicosis with toxic single thyroid nodule with thyrotoxic crisis or storm
E05.20Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm
E05.21Thyrotoxicosis with toxic multinodular goiter with thyrotoxic crisis or storm
E05.30Thyrotoxicosis from ectopic thyroid tissue without thyrotoxic crisis or storm
E05.31Thyrotoxicosis from ectopic thyroid tissue with thyrotoxic crisis or storm
E05.40Thyrotoxicosis factitia without thyrotoxic crisis or storm
E05.41Thyrotoxicosis factitia with thyrotoxic crisis or storm
E05.80Other thyrotoxicosis without thyrotoxic crisis or storm
E05.81Other thyrotoxicosis with thyrotoxic crisis or storm
E05.90Thyrotoxicosis, unspecified without thyrotoxic crisis or storm
E05.91Thyrotoxicosis, unspecified with thyrotoxic crisis or storm
E06.0Acute thyroiditis
E06.1Subacute thyroiditis
E06.9Thyroiditis, unspecified
E07.0Hypersecretion of calcitonin
E07.1Dyshormogenetic goiter
E07.89Other specified disorders of thyroid
E07.9Disorder of thyroid, unspecified
E21.4Other specified disorders of parathyroid gland
E35Disorders of endocrine glands in diseases classified elsewhere
K12.2Cellulitis and abscess of mouth
L02.01Cutaneous abscess of face
L02.11Cutaneous abscess of neck
L03.211Cellulitis of face
L03.212Acute lymphangitis of face
L03.221Cellulitis of neck
L03.222Acute lymphangitis of neck
Q89.2Congenital malformations of other endocrine glands
R22.0Localized swelling, mass and lump, head
R22.1Localized swelling, mass and lump, neck
R59.0Localized enlarged lymph nodes
R59.1Generalized enlarged lymph nodes
R59.9Enlarged lymph nodes, unspecified
R90.0Intracranial space-occupying lesion found on diagnostic imaging of central nervous system
R94.6Abnormal results of thyroid function studies
Z85.850Personal history of malignant neoplasm of thyroid
Z92.3Personal history of irradiation

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