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ICD-9-CM Codes

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  • 244 Acquired hypothyroidism

  • 244.0 Postsurgical hypothyroidism

  • 244.1 Other postablative hypothyroidism

  • 244.2 Iodine hypothyroidism

  • 244.3 Other iatrogenic hypothyroidism

  • 244.8 Other specified acquired hypothyroidism

  • 244.9 Unspecified acquired hypothyroidism

  • Associated ICD-9-CM PT diagnoses/treatment diagnoses that may be directly related

    • 315.4 Developmental coordination disorder

    • 718.45 Contracture of joint, pelvic region and thigh

    • 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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  • E03.9 Hypothyroidism, unspecified

  • E89.0 Post-procedural hypothyroidism

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Preferred Practice Patterns1

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Key Features

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Description

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  • A deficiency of thyroid gland activity

  • Characterized by decreased basal metabolic rate, fatigue and lethargy, sensitivity to cold, and menstrual disturbances

  • In infants, severe hypothyroidism leads to cretinism

  • Thyroid regulates metabolism and produces three types of thyroid hormone2

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Essentials of Diagnosis

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  • Gradual onset

  • Palpation of thyroid/neck for enlargement of thyroid or any abnormalities

  • Thyroid function test

  • 3 types of hypothyroidism

    • Primary: thyroid gland dysfunction

    • Secondary: pituitary gland dysfunction

    • Tertiary: hypthalamus dysfunction

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General Considerations

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  • Can progress to myxedema if untreated

  • Thyroid needs iodine as a critical element2

  • May cause pathology in multiple organ systems

    • GI: liver

    • Cardiovascular: heart, peripheral circulation, blood pressure

    • Integumentary

  • May result in secondary problems indicating the need for PT intervention depending on severity

    • Aerobic capacity and muscle endurance impairment

    • Sarcopenia

    • Weakness/impaired muscle performance

    • Musculoskeletal problems

    • Neuromuscular problems

    • Weight gain, indicating the need for PT intervention depending on severity

  • Hyperlipidemia

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Demographics

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  • Affects individuals through lifespan, starting at birth (1 in 4,000 infants)

  • Estimated 5 million in the U.S. and possibly double that are undiagnosed

  • Higher incidence in women

  • Higher incidence in those greater than age 60

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Clinical Findings

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Signs and Symptoms

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  • Cold sensitivity

  • Fatigue

  • Weight gain

  • Slowed heart rate

  • Constipation

  • Joint pain

  • Muscle pain

  • Muscle cramps

  • Paleness

  • Dry skin

  • Hair thinning, including eyebrows

  • Brittleness of fingernails

  • Weakness

  • Unexplained weight gain with inability to lose it

  • Depression

  • Heavier menstrual periods

  • Decreased ability to smell

  • Decreased taste

  • Puffiness of hands, feet, and face

  • Peripheral neuropathy/numbness

  • Slowness of speech

  • Thickening of skin

  • Liver dysfunction

  • Heart disease

  • Worsening of angina if history of angina

  • Anemia

  • In severe cases

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Functional Implications

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