ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 E04.1

Billable / Specific

Nontoxic single thyroid nodule

E04
Block
3
Synonyms
357
LCDs
13
Payer Policies
2
Linked CPTs

About ICD-10-CM E04.1

ICD-10-CM code E04.1 represents Nontoxic single thyroid nodule. This is a billable/specific code in the Endocrine, Nutritional, and Metabolic chapter (block E04). The 2026 edition of ICD-10-CM E04.1 became effective on October 1, 2025.

Inclusion Terms / Approximate Synonyms

Clinical terms and conditions classified under E04.1. Per CMS ICD-10-CM Tabular 2026.

  • Colloid nodule (cystic) (thyroid)
  • Nontoxic uninodular goiter
  • Thyroid (cystic) nodule NOS

Medicare LCD Coverage for E04.1

Local Coverage Determinations (LCDs) from CMS MACs that list E04.1 as a covered diagnosis.

357 LCDs

Showing top 10 of 357 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85651 →
CMS LCD: Billing and Coding: Sedimentation Rate, Erythrocyte
Article ID: 57657, Effective: 2024-10-01 00:00:00, 1430 covered, 1 non-covered
CPT 85652 →
CMS LCD: Billing and Coding: MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules
Article ID: 59509, Effective: 2026-02-05 00:00:00, 10 covered, 0 non-covered
CPT 81479 →
CMS LCD: Billing and Coding: MolDX: Molecular Testing for Risk Stratification of Thyroid Nodules
Article ID: 59509, Effective: 2026-02-05 00:00:00, 10 covered, 0 non-covered
CPT 81546 →
CMS LCD: Billing and Coding: Biomarkers for Oncology
Article ID: 52986, Effective: 2025-04-24 00:00:00, 427 covered, 1 non-covered
CPT 81316 →
CMS LCD: Billing and Coding: Biomarkers for Oncology
Article ID: 52986, Effective: 2025-04-24 00:00:00, 427 covered, 1 non-covered
CPT 81357 →
CMS LCD: Billing and Coding: Biomarkers for Oncology
Article ID: 52986, Effective: 2025-04-24 00:00:00, 427 covered, 1 non-covered
CPT 81348 →
CMS LCD: Billing and Coding: Biomarkers for Oncology
Article ID: 52986, Effective: 2025-04-24 00:00:00, 427 covered, 1 non-covered
CPT 81170 →
CMS LCD: Billing and Coding: Biomarkers for Oncology
Article ID: 52986, Effective: 2025-04-24 00:00:00, 427 covered, 1 non-covered
CPT 81275 →
CMS LCD: Billing and Coding: Biomarkers for Oncology
Article ID: 52986, Effective: 2025-04-24 00:00:00, 427 covered, 1 non-covered
CPT 81262 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing E04.1.

13 policies

5 Medicare

Billing and Coding: Biomarkers for Oncology
Policy ID: ART-52986
Billing and Coding: Computerized Axial Tomography (CT), Thorax
Policy ID: ART-56580
Billing and Coding: Magnetic Resonance Imaging of the Head and Neck
Policy ID: ART-56729
Billing and Coding: Ultrasound, Soft Tissues of Head and Neck
Policy ID: ART-57029
Billing and Coding: MRI and CT Scans of the Head and Neck
Policy ID: ART-57204

1 Aetna

Prolotherapy and Sclerotherapy
Policy ID: CPB-0207

CPT Codes Commonly Billed with E04.1

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

2 linkages
  • 76942 Ultrasound-guided thyroid biopsy — thyroid nodule, multinodular goiter, hyperthyroidism, thyroiditis, thyroid cancer, thyroid neoplasm, lymphadenopathy, abnormal thyroid function Endocrinology
  • 76536 CMS LCD: Billing and Coding: Ultrasound, Soft Tissues of Head and Neck CMS LCD

Convert E04.1 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
E04.1 2410 10000
E04.1 2462 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 E04.1, Billing FAQ

Is ICD-10 code E04.1 billable? +

Yes, E04.1 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What other names or terms map to E04.1? +

ICD-10 E04.1 includes: Colloid nodule (cystic) (thyroid); Nontoxic uninodular goiter; Thyroid (cystic) nodule NOS.

What CPT codes are commonly billed with E04.1? +

Procedures frequently paired with E04.1 include: 76942, 76536.

What ICD-9 codes does E04.1 map to? +

Per CMS GEMs, E04.1 maps to ICD-9 codes: 2410, 2462. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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