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E03.5

(MYXEDEMA COMA)

Myxedema (crisis) coma is a loss of brain function as a result of the severe, longstanding low level of thyroid hormone in the blood (hypothyroidism). Myxedema coma is considered a rare life-threatening complication of hypothyroidism and represents one of the more serious sides of thyroid disease.

SYMPTOMS

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• Weakness or lethargy.
• Confusion or non-responsiveness.
• Feeling cold.
• Low body temperature.
• Swelling of the body, especially the face, tongue, and lower legs.
• Difficulty breathing.

Myxedema coma occurs as a result of long-standing, undiagnosed, or undertreated hypothyroidism and is usually precipitated by a systemic illness. Myxedema coma can result from any of the causes of hypothyroidism, most commonly chronic autoimmune thyroiditis.

Treatment involves administering thyroid hormone replacement medication into a vein. Antibiotics, steroid treatment, and breathing support may be necessary also. A person may need breathing assistance, such as continuous positive airway pressure (CPAP) if carbon dioxide levels in the blood are very high.

Myxedema crisis is a life-threatening extreme form of hypothyroidism with a high mortality rate if left untreated. Myxedema crisis is commonly seen in older patients, especially women, and is associated with signs of hypothyroidism, hypothermia, hyponatremia, hypercarbia, and hypoxemia.

Anyone with hypothyroidism, a history of neck surgery, or radioactive iodine treatment could be at risk for this life-threatening complication. However, there are some higher risk groups, according to Dr. Leanna Poston, such as older women (over the age of 60) who have a history of primary hypothyroidism.

- It is generally deemed prudent to treat with hydrocortisone because of the possibility of coexistent primary or secondary adrenal insufficiency but also because of the possibility that thyroid hormone therapy may increase cortisol clearance and precipitate adrenal insufficiency.

Myxedema is another term for severely advanced hypothyroidism. This is a condition that occurs when your body doesn't produce enough thyroid hormone. The thyroid is a small gland that sits right at the front of your neck.

• E03.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
• The 2022 edition of ICD-10-CM E03.5 became effective on October 1, 2021.
• This is the American ICD-10-CM version of E03.5 - other international versions of ICD-10 E03.5 may differ.

The following code(s) above E03.5 contain annotation back-references

 that may be applicable to E03.5:

• E00-E89 
   Endocrine, nutritional and metabolic diseases
• E03 
   Other hypothyroidism

ICD-10-CM E03.5 is grouped within Diagnostic Related Group(s) (MS-DRG v39.0):

• 080 Nontraumatic stupor and coma with mcc
• 081 Nontraumatic stupor and coma without mcc
• 791 Prematurity with major problems
• 793 Full term neonate with major problems

Convert E03.5 to ICD-9-CM

Code History

• 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)
• 2017 (effective 10/1/2016): No change
• 2018 (effective 10/1/2017): No change
• 2019 (effective 10/1/2018): No change
• 2020 (effective 10/1/2019): No change
• 2021 (effective 10/1/2020): No change
• 2022 (effective 10/1/2021): No change

Diagnosis Index entries containing back-references to E03.5:

• Coma R40.20
  • myxedematous E03.5
• Myxedema (adult) (idiocy) (infantile) (juvenile) E03.9
   - see also Hypothyroidism
• coma E03.5

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