E04.8 ICD-10-CM Code: Other specified nontoxic goiter
E04.8 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC coding software
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Disorders of thyroid gland (E00-E07)
E04.8
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceOther specified nontoxic goiter
An enlarged thyroid gland that is not producing excess hormone, caused by conditions not covered by the more specific nontoxic goiter codes.
Buddy Insight
Other specified nontoxic goiter captures thyroid enlargement with preserved euthyroid function that does not fit the diffuse, single nodule, or multinodular categories.
CMS-HCC V28
N/A—
Not mapped
CMS-HCC V24
HistoricalHistorical
Not used for CY2026 payment
ACA/HHS
N/A—
Not mapped
ESRD/PACE
N/A—
Not mapped
RXHCC
MappedHCC 44
Code-level coefficient reference
Code Book Path
Inclusion Terms
OfficialNo inclusion terms are included in this display for E04.8. Check the code and parent instructions in the Code Book.
Excludes 2
OfficialNo Excludes 2 notes are included in this display for E04.8. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for E04.8. Check the code and parent instructions in the Code Book.
Excludes 1
Official- transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89, E04
- congenital goiter (NOS) (diffuse) (parenchymatous) (E03.0)Inherited from E00-E89, E04
- iodine-deficiency related goiter (E00-E02)Inherited from E00-E89, E04
Code First
OfficialNo Code First sequencing instructions are included in this display for E04.8. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for E04.8. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for E04.8. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
Common Mistakes
Current with CMS: FY2026 ICD-10-CM Apr 1 update (effective Apr 1 – Sep 30, 2026) · CMS-HCC V28, 100% phased in for payment year 2026. FY2027 code set already staged for October 1, 2026. How HCC Buddy stays current →
Is E04.8 an HCC code?
E04.8 is not in the CMS-HCC V28 or V24 community payment model. E04.8 has a separate mapping under the Part D RxHCC model (HCC 44 (Thyroid Disorders)); the applicable result needs member context.
- Code
- E04.8
- Description
- Other specified nontoxic goiter
- HCC (V28)
- No CMS-HCC V28 mapping
- RAF reference coefficient
- —
- Billable
- Yes
- Payment year
- 2026
HCC Category Mapping
These are source-labeled model coefficients, not member totals. A category may still be removed by hierarchy or model cleanup rules. Weights are not directly comparable across models: CMS-HCC V28 and V24 use Community, Non-Dual, Aged; ESRD uses the dialysis continuing-enrollee model; RxHCC is the Part D continuing-enrollee, non-low-income, aged weight (a larger scale than CMS-HCC). ACA/HHS has no single weight — it varies by metal level. Actual per-patient RAF contribution depends on member context, hierarchy and cleanup rules, interactions, and the model year used by the payer. V28 is the CMS-HCC model phased in over payment years 2024–2026; V24 remains available for historical review.
Work E04.8 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for E04.8
For E04.8, confirm that the documentation supports the diagnosis and meets the applicable coding, encounter, program and payer requirements. MEAT (Monitor, Evaluate, Assess, or Treat) is a review mnemonic, not a universal CMS coding rule.
- 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
Coder workflow notes
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What This Code Means
E04.8 is the ICD-10-CM diagnosis code for other specified nontoxic goiter. An enlarged thyroid gland that is not producing excess hormone, caused by conditions not covered by the more specific nontoxic goiter codes. E04.8 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).
E04.8 has no mapping under the CMS-HCC V28 or V24 community payment models. E04.8 has a separate mapping under the Part D RxHCC model (HCC 44 (Thyroid Disorders)); the applicable result needs member context. Do not assign V28 risk adjustment value from this page; verify the applicable model and payment year before using this code for risk adjustment.
Use this code for unusual causes of nontoxic goiter such as iodine excess, infiltrative diseases, or other rare conditions.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E04.8 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Use this code for unusual causes of nontoxic goiter such as iodine excess, infiltrative diseases, or other rare conditions
- •Always document the specific etiology in the medical record to justify use of this code
Clinical Significance
Other specified nontoxic goiter captures thyroid enlargement with preserved euthyroid function that does not fit the diffuse, single nodule, or multinodular categories. This includes asymmetric goiter, goiter with substernal extension, and other morphologically distinct patterns of thyroid enlargement. Substernal goiter in particular can cause significant compressive symptoms including tracheal deviation, superior vena cava syndrome, and recurrent laryngeal nerve palsy.
Documentation Requirements
- ✓Documentation should describe the specific type of nontoxic goiter that does not fit the standard categories, with thyroid function tests confirming euthyroid status.
- ✓Imaging findings (ultrasound, CT of neck/chest for substernal extension) and assessment for compressive symptoms should be documented.
- ✓Surgical evaluation and referral should be noted when indicated for symptomatic goiters.
Commonly Confused Codes
- •E04.0 (Nontoxic diffuse goiter), E04.1 (Nontoxic single thyroid nodule), and E04.2 (Nontoxic multinodular goiter) are more specific and should be used when the pattern fits.
- •E04.9 (Nontoxic goiter, unspecified) is less specific and should not be used when a specific morphology is documented.
- •J98.09 (Other diseases of mediastinum) might be considered for substernal extension but does not replace the thyroid code.