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Hashimoto's thyroiditis C034

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

SOP Bulletin 165

 ICD Coding:
  • ICD-9-CM Codes: 245.2
  • ICD-10-AM Codes: E06.3

Chronic autoimmune inflammation of the thyroid gland named after Japanese surgeon Dr Hakuru Hashimoto in 1912, in which the body develops cytotoxic antibodies to the thyroid gland (anti thyroid peroxidase (TPO) and anti thyroglobulin antibodies (Tg). The antibodies destroy the thyroid gland producing a brief hyperthyroidism due to the leakage of thyroid hormone from the gland during destruction, and then a residual hypothyroidism since the thyroid can no longer produce sufficient thyroxine for normal metabolic activities.

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

Diagnosis is based on clinical manifestations and blood tests.  The appropriate specialist is an endocrinologist.

Are there sub-factors that require specific information? – No.
Additional diagnoses covered by SOP
  • Chronic lymphocytic thyroiditis
  • Hashimoto’s disease
  • Hashitoxicosis
  • Ord’s disease – primary hypothyroidism with thyroid atrophy
Conditions excluded from SOP
  • Acute thyroiditis, ICD code 245.0
  • Goitre (other than due to Hashimoto’s thyroiditis), ICD codes 240, 241, 242.1-3
  • Hyperthyroidism, ICD code 242.9
  • Hypothyroidism (other than due to Hashimoto’s thyroiditis), ICD code 244.9
  • Non-autoimmune chronic thyroiditis, ICD code 245.3,8
  • Secondary hypothyroidism, ICD code 244.8
  • Subacute thyroiditis, ICD code 245.1
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