E05.41
BillableThyrotoxicosis factitia with thyrotoxic crisis or storm
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is E05.41 an HCC code?
No. E05.41 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 E05.41
For E05.41to 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 E05.41 during that encounter — not just copy-forwarded from a problem list.
What This Code Means
E05.41 is the ICD-10-CM diagnosis code for thyrotoxicosis factitia with thyrotoxic crisis or storm. Overactive thyroid caused by taking too much thyroid hormone medication, with thyroid storm (severe, life-threatening condition). E05.41 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).
E05.41 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.
Maps to RxHCC 44 (Osteoporosis, Vertebral and Pathological Fractures) in the prescription drug model. Despite the acute severity requiring intensive care, this code does not map to CMS-HCC v28 or v24 models. The RxHCC mapping captures the prescription drug risk associated with thyroid hormone management.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for E05.41 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the source of excess thyroid hormone (prescribed medication, supplements, or intentional overdose)
- •Assign external cause codes to indicate how the overdose occurred
Clinical Significance
Thyrotoxicosis factitia with thyrotoxic crisis represents a medical emergency caused by excessive exogenous thyroid hormone intake resulting in thyroid storm. This iatrogenic or self-induced crisis presents with the same life-threatening systemic decompensation as endogenous thyroid storm, including hyperpyrexia, cardiovascular collapse, and encephalopathy. Prognosis depends on rapid identification of the exogenous source and aggressive supportive care.
Documentation Requirements
- ✓Document the exogenous thyroid hormone source, dosage, duration of exposure, and clinical criteria for thyroid storm (fever, tachycardia, altered mental status, cardiovascular decompensation).
- ✓Record Burch-Wartofsky scoring if available, ICU admission, and beta-blocker and supportive therapy administered.
- ✓An external cause code should be considered.
Commonly Confused Codes
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