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CONDITION/DISORDER SYNONYM

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  • Overactive thyroid

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ICD-9-CM CODES

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  • 242.20 Toxic multinodular goiter without mention of thyrotoxic crisis or storm

  • 242.90 Thyrotoxicosis without mention of goiter or other cause, and without mention of thyrotoxic crisis or storm

  • PT diagnosis codes that may be secondary to thyroid disorders

    • 315.4 Developmental coordination disorder

    • 709.2 Scar conditions and fibrosis of the skin

    • 719.70 Difficulty in walking involving joint site unspecified

    • 728.2 Muscular wasting and disuse atrophy, not elsewhere classified

    • 728.89 Other disorders of muscle, ligament, and fascia

    • 729.9 Other and unspecified disorders of soft tissue

    • 780.7 Malaise and fatigue

    • 781.2 Abnormality of gait

    • 782.3 Edema

    • 786.0 Dyspnea and respiratory abnormalities

    • 786.05 Shortness of breath

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ICD-10-CM CODES

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  • E05.20 Thyrotoxicosis with toxic multinodular goiter without thyrotoxic crisis or storm

  • E05.90 Thyrotoxicosis, unspecified without thyrotoxic crisis or storm

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PREFERRED PRACTICE PATTERNS1

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  • 4D: Impaired Joint Mobility, Motor Function, Muscle Performance, and Range of Motion Associated with Connective Tissue Dysfunction

  • 6B: Impaired Aerobic Capacity/Endurance Associated with Deconditioning

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FIGURE 27-1

Algorithm for thyroid function tests. This algorithm does not apply in patients with hypothalamic–pituitary disease, serious illness, or those who are taking certain medications such as amiodarone, glucocorticoids, and dopamine. (From McKean SC, Ross JJ, Dressler DD, Brotman DJ, Ginsberg JS. Principles and Practice of Hospital Medicine. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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FIGURE 27-2

Hyperthyroidism: laboratory evaluation. FT4, free thyroxine; T3, 3,5,3’-triiodothyronine; TSH, thyroid-stimulating hormone. (Modified with permission from Gardner DG, Shoback D, eds. Greenspan’s Basic & Clinical Endocrinology. 9th ed. Originally published by Appleton & Lange. Copyright © 2011 by the McGraw-Hill Companies, Inc.)

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PATIENT PRESENTATION

A 47-year-old female has been suffering from bilateral shoulder pain for the last 2 months, which increases with dressing her upper body and washing her head. She reports a decreased ability to perform her job as an administrative assistant for a lawyer’s firm because of pain, difficulty in concentrating which she attributes to being concerned about her shoulder pain, and increased frequency of urination requiring her to leave her workstation several times during the day. She reports that she enjoys running; however, was unable to finish her last 5K because of heat intolerance and palpitations. She has noticed weight loss, however, reports feeling hungry at all times. Upon examination patient presents with clammy skin and mild exophthalmos. Vital signs were normal except heart rate of 110 bpm at rest. ROM was limited in bilateral shoulders. MMT was decreased in bilateral shoulders and bilateral hip flexors. Gait was normal. Endurance was impaired by demonstrating abnormally increased vitals after a gait assessment on short distance. Patient presents with limited ability to perform ...

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