2027 ICD-10-CM Diagnosis Code E04.2Nontoxic multinodular goiter
ICD-10-CM Codes›E00–E89›E00-E07›E04
- Billable — Valid for Submission
- Chronic Condition
E04.2 is a billable ICD-10-CM diagnosis code for nontoxic multinodular goiter. It is valid on HIPAA claims for fiscal year 2027 (October 1, 2026 through September 30, 2027) and groups to MS-DRG 643 through 645. Coders also document this condition as autosomal dominant polycystic kidney disease. In AHRQ's Clinical Classifications Software (CCSR), this diagnosis falls under Thyroid disorders.
E04.2 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 44 for payment year 2027.
Code Identity
Code Classification
Medicare Risk Adjustment (HCC)Billing
E04.2 does not risk-adjust for Medicare Advantage under the CMS-HCC V28 model, but it maps to payment categories in the other CMS models shown below.
Source: CMS Payment Year 2027 risk adjustment mappings and model software. Weights are relative factors, not dollar amounts; a beneficiary's total RAF also includes demographics and interactions. Browse all CMS-HCC categories.
Approximate SynonymsGuidance
Alternate terms and clinical phrases that map to this code.
- Autosomal dominant polycystic kidney disease
- Congenital goiter
- Familial multinodular goiter syndrome
- Multinodular goiter
- Multinodular goiter, cystic kidney, polydactyly syndrome
- Non-toxic multinodular goiter
- Non-toxic nodular goiter
- Simple goiter
- Thyroid follicular nodular disease
Instructional NotesGuidance
Instructions from the official ICD-10-CM Tabular List that apply to E04.2: its own notes plus those printed at E04 and Chapter 4. A note printed at a category, block or chapter applies to every code under it.
Applicable To
Conditions this code is used for: synonyms of the title or, for "other specified" codes, the conditions assigned to it. The list is not exhaustive.
- Cystic goiter NOS
- Multinodular (cystic) goiter NOS
Excludes1
Not coded here: the excluded code is never reported together with this one, unless the two conditions are unrelated.
Notes
General instructions on how these codes are used.
- All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Source: CMS ICD-10-CM Tabular List. How to read instructional notes.
Referenced in Other NotesGuidance
Instructional notes printed at other codes that name E04.2, its category, or a range that includes it.
Applicable To 1
These notes mention E04.2.
- Z83.4 Family history of other endocrine, nutritional and metabolic diseases
Code First 1
These codes say to code first a condition named in the note, and E04.2 is one of the conditions named.
- G63 Polyneuropathy in diseases classified elsewhere
Index to Diseases and InjuriesGuidance
Alphabetical index entries that point to this code.
Goiter (plunging) (substernal) E04.9
cystic E04.2
multinodular E04.2
Struma See Also: Goiter;
Clinical ClassificationClinical
AHRQ’s CCSR groups this code into broader clinical categories.
Clinical InformationClinical
Non-Toxic Multinodular Goiter
a multinodular goiter that is not associated with changes in thyroid function or malignancy.
Patient EducationClinical
Thyroid Diseases
Your thyroid is a small, butterfly-shaped gland in the front of your neck. It makes hormones that control the way the body uses energy. These hormones affect nearly every organ in your body and control many of your body's most important functions. For example, they affect your breathing, heart rate, weight, digestion, and moods.
Read the full article at MedlinePlus
Courtesy of MedlinePlus, a service of the U.S. National Library of Medicine.
Convert E04.2 to ICD-9-CMHistory
The closest ICD-9-CM equivalents under the General Equivalence Mappings.
Code HistoryHistory
Questions About E04.2Overview
What is the ICD-10 code for nontoxic multinodular goiter?
The ICD-10-CM code for nontoxic multinodular goiter is E04.2 (sometimes written as E042). It is billable on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
Is E04.2 (Other nontoxic goiter) a billable code?
Yes. This is a billable ICD-10-CM code, specific enough to report nontoxic multinodular goiter on HIPAA-covered claims from October 1, 2026 through September 30, 2027.
What MS-DRG does E04.2 group to?
When nontoxic multinodular goiter is the principal diagnosis on an inpatient stay, it groups to MS-DRG 644, 645, 643, with relative weights from 0.7461 to 1.6138 depending on complications. Higher weights mean higher Medicare reimbursement.
Can E04.2 be reported with E03.0?
Not as a rule. The Excludes1 note at E04, which applies to E04.2, lists "congenital goiter (NOS) (diffuse) (parenchymatous) (E03.0)". An Excludes1 note means the excluded code is never reported together with this one; the only exception is when the two conditions are unrelated to each other (Official Guidelines, Section I.A.12.a).
What is the ICD-9 equivalent of E04.2?
Under the General Equivalence Mappings, nontoxic multinodular goiter converts to ICD-9-CM 241.1 (nontox multinodul goiter). The mapping is approximate, so confirm the match fits the documentation.
Does E04.2 risk-adjust for Medicare Advantage payment?
Not for Medicare Advantage: E04.2 maps to no category in the CMS-HCC V28 model. It still risk-adjusts in the RxHCC Part D (V08) category 44 (Thyroid Disorders).
