Coverage of Thryoid Function Studies
Coverage of Thryoid Function Studies
Thyroid function studies are used to delineate the presence or absence of hormonal abnormalities of the thyroid. These abnormalities may be either primary or secondary and usually accompany clinically well-defined signs and symptoms indicative of thyroid dysfunction. Serum levels of thyroid hormone are useful to confirm clinical hyperfunction, hypofunction or euthyroidism of the thyroid gland.
Thyroid function tests should not be performed without the presence of at least some supporting signs or symptoms of hyperthyroidism, hypothyroidism or thyroid mass (eg, tachycardia, bradycardia, tremor, fine or thick skin, sweating, weight changes, bowel changes, eyelid edema, exophthalmus, reflex changes, hearing loss, personality changes, swelling, thyroid masses, tenderness or prior abnormal thyroid function tests). Thyroid testing would be appropriate if thyroid disease is suspected, and there is an unexplained aspect of a patient's condition that could be accounted for by thyroid disease.
Laboratory analysis to detect thyroid function has become more scientifically defined. Tests can be done with increased specificity, thereby reducing the number of tests needed to diagnose and follow treatment of most thyroid disease. The American Thyroid Association recommends the measurement of serum sensitive thyroid-stimulating hormone (sTSH) levels complemented by an appropriate free thyroxine (FT4) estimate to represent the best and most efficient combination of blood tests for diagnosis and follow-up of most patients with thyroid disorders. This is true for most ambulatory patients. This recommendation is not to be used for certain complex diagnostic problems or on an inpatient basis, where many circumstances can skew test results.
Thyroid function levels do not determine the etiology of thyroid disease. Thyroid testing is reasonable and necessary to:
Thyroid function testing is medically necessary in patients with disease and neoplasm of the thyroid and other endocrine glands, metabolic disorders including malnutrition, hyperlipidemia, certain types of anemia, psychosis and nonpsychotic personality disorders, ophthalmologic disorders, various cardiac arrhythmias, disorders of menstruation, skin conditions, patients receiving amiodarone, and myalgias. Thyroid function testing is medically necessary as well in patients with a wide array of signs and symptoms, including alterations in consciousness, malaise, hypothermia, symptoms of the nervous and musculoskeletal system, skin and integumentary system, nutrition and metabolism, cardiovascular and gastrointestinal system. It is not medically necessary to perform follow-up thyroid testing in patients with a personal history of malignant neoplasm of the endocrine system, or in patients on long-term drug therapy.
Thyroid function studies are used to delineate the presence or absence of hormonal abnormalities of the thyroid. These abnormalities may be either primary or secondary and usually accompany clinically well-defined signs and symptoms indicative of thyroid dysfunction. Serum levels of thyroid hormone are useful to confirm clinical hyperfunction, hypofunction or euthyroidism of the thyroid gland.
Thyroid function tests should not be performed without the presence of at least some supporting signs or symptoms of hyperthyroidism, hypothyroidism or thyroid mass (eg, tachycardia, bradycardia, tremor, fine or thick skin, sweating, weight changes, bowel changes, eyelid edema, exophthalmus, reflex changes, hearing loss, personality changes, swelling, thyroid masses, tenderness or prior abnormal thyroid function tests). Thyroid testing would be appropriate if thyroid disease is suspected, and there is an unexplained aspect of a patient's condition that could be accounted for by thyroid disease.
Laboratory analysis to detect thyroid function has become more scientifically defined. Tests can be done with increased specificity, thereby reducing the number of tests needed to diagnose and follow treatment of most thyroid disease. The American Thyroid Association recommends the measurement of serum sensitive thyroid-stimulating hormone (sTSH) levels complemented by an appropriate free thyroxine (FT4) estimate to represent the best and most efficient combination of blood tests for diagnosis and follow-up of most patients with thyroid disorders. This is true for most ambulatory patients. This recommendation is not to be used for certain complex diagnostic problems or on an inpatient basis, where many circumstances can skew test results.
Thyroid function levels do not determine the etiology of thyroid disease. Thyroid testing is reasonable and necessary to:
distinguish between primary and secondary hypothyroidism;
distinguish between primary and secondary hyperthyroidism;
confirm or rule out primary hypothyroidism;
confirm or rule out primary hyperthyroidism;
monitor thyroid hormone levels; and
monitor drug therapy in patients with primary hypothyroidism.
Thyroid function testing is medically necessary in patients with disease and neoplasm of the thyroid and other endocrine glands, metabolic disorders including malnutrition, hyperlipidemia, certain types of anemia, psychosis and nonpsychotic personality disorders, ophthalmologic disorders, various cardiac arrhythmias, disorders of menstruation, skin conditions, patients receiving amiodarone, and myalgias. Thyroid function testing is medically necessary as well in patients with a wide array of signs and symptoms, including alterations in consciousness, malaise, hypothermia, symptoms of the nervous and musculoskeletal system, skin and integumentary system, nutrition and metabolism, cardiovascular and gastrointestinal system. It is not medically necessary to perform follow-up thyroid testing in patients with a personal history of malignant neoplasm of the endocrine system, or in patients on long-term drug therapy.
