E01.2
BillableIodine-deficiency related (endemic) goiter, unspecified
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E01.2 an HCC code?
No. E01.2 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
HCC Category Mapping
RAF weights shown are the community, non-dual, aged base weights from the CMS risk adjustment model file. Actual per-patient RAF contribution depends on member segment, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains in use during the transition and for historical data.
MEAT Criteria for E01.2
For E01.2to count as a valid HCC diagnosis in a given encounter, the provider's documentation must show MEAT: Monitor, Evaluate, Assess, or Treat. A diagnosis from a prior year does not carry forward automatically — it has to be re-documented and supported each calendar year.
- MMonitor: signs, symptoms, disease progression, or lab trending documented in the note
- EEvaluate: test results, medication response, or physical findings reviewed by the provider
- AAssess: explicit mention in the assessment or plan with acknowledgment of status
- TTreat: medication, referral, procedure, therapy, or counseling tied to the diagnosis
Only one of M/E/A/T is required to support the code, but the documentation must be specific enough to show that the provider actually addressed E01.2 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E01.2 is the ICD-10-CM diagnosis code for iodine-deficiency related (endemic) goiter, unspecified. This code describes an enlarged thyroid gland (goiter) caused by iodine deficiency in areas where this condition is common in the population. The specific type or severity of the goiter is not specified in the medical record. E01.2 sits in the ICD-10-CM chapter for endocrine, nutritional and metabolic diseases (e00-e89), within the section covering disorders of thyroid gland (e00-e07).
E01.2 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
This code does not map to any HCC under V24 or V28, providing no community risk adjustment impact. It maps to RxHCC 44 (Osteoporosis, Vertebral and Pathological Fractures). The clinical value lies in identifying the iodine-deficiency etiology for appropriate management.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E01.2 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code only when iodine deficiency is documented as the cause and the goiter is endemic (occurring in a specific geographic region); do not use for non-endemic goiter
- •If the medical record specifies the type of iodine-deficiency goiter (such as diffuse or nodular), use the more specific subcategories E01.0 or E01.1 instead of E01.2
Clinical Significance
Iodine-deficiency related (endemic) goiter, unspecified, captures thyroid enlargement due to iodine deficiency where the morphology (diffuse versus multinodular) has not been specified. This is a less clinically informative code that should prompt further characterization through thyroid imaging. The distinction between diffuse and multinodular patterns has implications for monitoring and management strategies.
Documentation Requirements
- ✓Documentation must confirm iodine-deficiency as the cause of the goiter.
- ✓The provider should be queried to specify whether the goiter is diffuse or multinodular, ideally based on ultrasound findings.
- ✓Thyroid function tests and any symptoms related to goiter size should be documented.
- ✓This code should be considered temporary pending more specific morphological characterization.
Commonly Confused Codes
- •E01.0 (Iodine-deficiency related diffuse goiter) and E01.1 (Iodine-deficiency related multinodular goiter) are more specific alternatives.
- •E04.9 (Nontoxic goiter, unspecified) captures unspecified goiter without iodine-deficiency etiology.
- •E04.0 (Nontoxic diffuse goiter) and E04.2 (Nontoxic multinodular goiter) are non-endemic alternatives.