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Graves' disease C017

Document
Last amended 
29 June 2015
Current RMA Instruments:
Reasonable Hypothesis SOP
33 of 2013
Balance of Probabilities SOP
34 of 2013
Changes from Previous Instruments:

SOP Bulletin 165

ICD Coding:
  • ICD-9-CM Codes: 242.0
  • ICD-10-AM Codes: E05.0

A systemic autoimmune disease in which the body develops antibodies to the thyroid stimulating receptors (TSH receptor antibodies). The antibodies stimulate the thyroid gland producing an enlarged thyroid and excessive circulating levels of thyroid hormones with symptoms and signs of hyperthyroidism resulting.

Additionally, the systemic autoimmune disease can interfere with other parts of the body causing bulging eyes and skin oedema.

Graves’ disease is the commonest cause (60-80%) of hyperthyroidism in Western countries and is excluded from the RMA SOP for hyperthyroidism.

Is specific diagnostic evidence required to apply the SOP? – No.

Diagnosis is based on clinical manifestations and blood tests showing elevated levels of thyroxine together with thyroid stimulating autoantibody. The appropriate specialist is an endocrinologist.

Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • Basedow’s disease
  • Diffuse toxic goitre
  • Exophthalmic goitre
  • Eye and skin manifestations of Graves’ disease
Conditions not covered by SOP
  • Hyperthyroidism (other than due to Graves’ disease), ICD code 242.9
  • Hypothyroidism, ICD code 244
  • Goitre (other than due to Graves’ disease), ICD codes 240, 241, 242.1-3
  • Thyrotoxicosis (other than due to Graves’ disease), ICD code 242.8,9
Unconfirmed diagnosis

If, after considering the above information you are unable to apply the SOP, you should then:

  1. seek medical officer advice about further investigation, or;
  2. generate a diagnostic report, or;
  3. re-encode the condition, if appropriate.

The following investigations may be useful in establishing the diagnosis.

  • report from treating specialist
  • results of thyroid hormone and antibody testing