Is E03.5 a billable ICD-10-CM code?

Yes. E03.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.

Where does E03.5 sit in the tabular list?

Endocrine, nutritional and metabolic diseases (E00-E89), in the block Disorders of thyroid gland (E00-E07).

What cannot be coded together with E03.5?

E03.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E03.5 (E03) and apply to it just the same.

E03.5

E03.5 — Myxedema coma

Billable / specific codeICD-10-CM

E03.5 is a billable, specific ICD-10-CM code for myxedema coma. It is valid for submission on a claim.

Excludes1 inherited from the categories above E03.5

These are not written on E03.5, but they bind it: a note on a category applies to every code beneath it. Billing E03.5 with anything listed here is a denial.

Written on E03 — Other hypothyroidism

iodine-deficiency related hypothyroidism (E00-E02)
postprocedural hypothyroidism (E89.0)

Risk adjustment

E03.5 risk-adjusts. Under the CMS-HCC V28 model it maps to this category:

HCC 202 Coma, Brain Compression/Anoxic Damage0.543 RAF

Coefficient shown for the Community Non-dual Aged segment. A higher HCC in the same hierarchy will suppress this one, so capturing it does not always add score.

Medicare coverage

E03.5 is named in 11 Medicare coverage policies — 11 listing it as supporting medical necessity. Which of them applies to you depends on your Medicare contractor, and coverage genuinely differs by state.

A56612Billing and Coding: CT of the Head
A56645Billing and Coding: Controlled Substance Monitoring and Drugs of Abuse Testing
A56773Billing and Coding: Neurophysiology Evoked Potentials (NEPs)
A56781Billing and Coding: Transthoracic Echocardiography (TTE)

How E03.5 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 E03.5.

Coma›myxedematous
Myxedema›coma

Code history

E03.5 has not changed since FY2024 — no addition, revision or deletion across the three most recent ICD-10-CM releases.

Related codes at this level

Codes that share E03. If E03.5 is not quite right, the correct code is usually one of these.

Questions about E03.5

Is E03.5 a billable ICD-10-CM code?: Yes. E03.5 is a billable, specific ICD-10-CM code and is valid for submission on a claim.
Where does E03.5 sit in the tabular list?: Endocrine, nutritional and metabolic diseases (E00-E89), in the block Disorders of thyroid gland (E00-E07).
What cannot be coded together with E03.5?: E03.5 carries Excludes1 notes, which means the conditions they list can never be coded together with it on the same encounter. Some are written on the categories above E03.5 (E03) and apply to it just the same.