E07.1 ICD-10-CM Code: Dyshormogenetic goiter
E07.1 is not a CMS-HCC payment code. MEAT criteria · RAF Calculator · HCC Buddy coding tools
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FY 2026 Apr update / Endocrine, nutritional and metabolic diseases (E00-E89) / Disorders of thyroid gland (E00-E07)
E07.1
Billable / SpecificICD-10-CMOfficial ICD-10-CMCodebook guidanceDyshormogenetic goiter
A goiter (enlarged thyroid) caused by defects in thyroid hormone synthesis, resulting in the thyroid enlarging to compensate for inadequate hormone production.
Buddy Insight
Dyshormogenetic goiter results from inherited enzymatic defects in thyroid hormone synthesis, causing compensatory thyroid gland enlargement due to chronic TSH stimulation.
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
Official- Dyshormonogenetic goiter
- Familial dyshormogenetic goiter
- Familial dyshormonogenetic goiter
- Pendred's syndrome
Excludes 2
OfficialNo Excludes 2 notes are included in this display for E07.1. Check the code and parent instructions in the Code Book.
Related Codes
Includes
OfficialNo Includes notes are included in this display for E07.1. Check the code and parent instructions in the Code Book.
Excludes 1
Official- transitory congenital goiter with normal function (P72.0)
- transitory endocrine and metabolic disorders specific to newborn (P70-P74)Inherited from E00-E89
Code First
OfficialNo Code First sequencing instructions are included in this display for E07.1. Check the code and parent instructions in the Code Book.
Use Additional
OfficialNo Use Additional Code instructions are included in this display for E07.1. Check the code and parent instructions in the Code Book.
Code Also
OfficialNo Code Also instructions are included in this display for E07.1. Check the code and parent instructions in the Code Book.
Buddy Documentation Tip
MEAT Support
Audit Caution
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 E07.1 an HCC code?
E07.1 is not in the CMS-HCC V28 or V24 community payment model. E07.1 has a separate mapping under the Part D RxHCC model (HCC 44 (Thyroid Disorders)); the applicable result needs member context.
- Code
- E07.1
- Description
- Dyshormogenetic 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 E07.1 in the Code Book — tabular path, V28 RAF reference, and MEAT checklist →
MEAT review for E07.1
For E07.1, 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
E07.1 is the ICD-10-CM diagnosis code for dyshormogenetic goiter. A goiter (enlarged thyroid) caused by defects in thyroid hormone synthesis, resulting in the thyroid enlarging to compensate for inadequate hormone production. E07.1 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).
E07.1 has no mapping under the CMS-HCC V28 or V24 community payment models. E07.1 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.
Document the specific enzymatic defect if identified through genetic testing.
HCC Buddy maintains structured V28 and V24 mapping, source-labeled coefficient references, and MEAT documentation criteria for E07.1 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Document the specific enzymatic defect if identified through genetic testing
- •Distinguish from iodine deficiency goiter (E01.2) and other causes of goiter
Clinical Significance
Dyshormogenetic goiter results from inherited enzymatic defects in thyroid hormone synthesis, causing compensatory thyroid gland enlargement due to chronic TSH stimulation. These are autosomal recessive disorders affecting various steps of thyroid hormone production including iodide trapping, organification, coupling, or deiodination defects. Early identification is crucial as untreated congenital hypothyroidism leads to irreversible neurodevelopmental impairment (cretinism).
Documentation Requirements
- ✓Document the specific enzymatic defect if identified, goiter characteristics (size, nodularity), thyroid function tests, family history of similar thyroid disease, and whether the condition was identified through newborn screening.
- ✓Record the levothyroxine replacement dose and adequacy of treatment based on TSH levels.
Excludes 1, Do NOT code together
- transitory congenital goiter with normal function (P72.0)