E03.1 — Congenital hypothyroidism without goiter
E03.1 is a billable, specific ICD-10-CM code for congenital hypothyroidism without goiter. It is valid for submission on a claim.
Inclusion terms
Alternative wordings a physician may use in the chart for this same code.
- Aplasia of thyroid (with myxedema)
- Congenital atrophy of thyroid
- Congenital hypothyroidism NOS
Other codes that can never be billed with E03.1
These codes carry an Excludes1 note pointing at E03.1. The conflict binds both ways, but ICD-10-CM only writes it down on one side — so you would not find this by reading E03.1 alone.
Risk adjustment
E03.1 does not map to an HCC and does not risk-adjust under CMS-HCC V28. That is normal — most ICD-10 codes do not. It still needs to be coded correctly; it just will not move a RAF score.
Medicare coverage
E03.1 is named in 2 Medicare coverage policies — 2 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.
- A57326Billing and Coding: Electrocardiograms
- A57361Billing and Coding: Monitored Anesthesia Care
How E03.1 is indexed
Coders do not find codes by browsing the tabular list — they look them up in the alphabetic index, under the word the physician wrote. These are the index entries that lead here, so you can see which chart wordings map to E03.1.
- Agenesis›thyroid(gland)
- Aplasia›thyroid(congenital) (with myxedema)
- Athyrea›congenital
- Hypoplasia, hypoplastic›thyroid(gland)
- Hypothyroidism›congenital(without goiter)
- Subthyroidism›congenital
- Absence›thyroid›congenital
- Atrophy, atrophic›thyroid›congenital(with myxedema)
- Atrophy, atrophic›thyroid›with cretinism
- Insufficiency, insufficient›thyroid›congenital
- Jaundice›newborn›due to or associated with›hypothyroidism, congenital
Related codes at this level
Codes that share E03. If E03.1 is not quite right, the correct code is usually one of these.
Questions about E03.1
- Is E03.1 a billable ICD-10-CM code?
- Yes. E03.1 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
- Where does E03.1 sit in the tabular list?
- Endocrine, nutritional and metabolic diseases (E00-E89), in the block Disorders of thyroid gland (E00-E07).