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The guidance specifies urgent referral actions, required laboratory confirmations (e.g., TSH, total/free T4, total T3, thyroid antibodies), and supporting documentation such as clinical notes and growth charts. It also outlines timeframes, confirmatory testing, and imaging use when indicated, with clear pathways for urgent phone consultation and subsequent specialist 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Table of Contents:\n\n1a)Congenital Hypothyroidism(Neonate)[ICD-9 Code:243.0]1b)Congenital Hypothyroidism (Child)[ICD-9 Code:243.0]2a)Acquired Hypothyroidism [ICD-9 Code:244.8]  \n2b)Autoimmune Thyroiditis/Hypothyroidism [ICD-9 Code:245.2]  \n3)Central Hypothyroidism [ICD-9 Code:253.4]4a)Acquired Hyperthyroidism [ICD-9 Code:242.9]4b)Autoimmune Hyperthyroidism(Grave's Disease)[ICD-9 Code:242.0]  \n5)Neonatal Hyperthyroidism [ICD-9 Code:775.3]  \n6)Goiter [ICD-9 Code:240.9]  \n7)Thyroid Nodule [ICD-9 Code:243.0]Thyroid:Key Facts(page 7)  \n8a)Diabetes Mellitus -Type 1 [ICD-9 Code:250.03]Type 2 [ICD-9 Code:250.02]8b)Hyperglycemia [ICD-9 Code:790.29]  \n9a)Impaired Glucose Tolerance [ICD-9 Code:790.22]9b)Impaired Fasting Glucose [ICD-9 Code:790.21]10a)Morbid Obesity [ICD-9 Code:278.01]10b)Acanthosis Nigricans [ICD-9 Code:701.2]Diabetes:Key Facts(page 9)(Table of contents continued on next page)  \n# Pediatric Endocrinology Referral Guidelines\n\nTable of Contents(continued):  \n11)Short Stature [ICD-9 Code:783.43]  \n12)Failure to Thrive [ICD-9 Code:783.41]  \nGrowth:Key Facts(pages 13 &14)  \n13a)Precocious Puberty/Premature Thelarche -Girls [ICD-9 Code:259.1]  \n## 13b)Precocious Puberty -Boys [ICD-9 Code:259.1]\n\nPrecocious Puberty:Key Facts (page 13)  \n14a)Premature Adrenarche -Girls [ICD-9 Code:255.2]  \n## 14b)Premature Adrenarche -Boys [ICD-9 Code:255.2]\n\n15)Delayed Puberty [ICD-9 Code:259.0]  \n## 1a)Congenital Hypothyroidism (Neonate)  [ICD-9 Code:243.0]\n\nReferral Timeframe  \nPre-Referral Workup  \n# Clinical Findings\n\nReferral Requirements  \n\n| ▶URGENT:  \u003Cbr>Call NP/MD on-call to  \u003Cbr>discuss and start  \u003Cbr>treatment.  \u003Cbr>On-Call Phone\\#  \u003Cbr>Day:  \u003Cbr>(312)996-1795  \u003Cbr>After Hours:  \u003Cbr>(312)649-2639   | ▶Confirmatory TSH,To   |\n| --- | --- |\n\ntal T4 or Free T4  \n▶All clinical notes and laboratory  \n● Neonate with abnormal  \nresults including growth chart  \nNewborn Screening Test  \n## 1b)Congenital Hypothyroidism (Child)[ICD-9 Code:243.0]\n\n# Clinical Findings\n\nReferral Timeframe  \nReferral Requirements  \nPre-Referral Workup  \n\n| ▶ First available  \u003Cbr>appointment,but call the  \u003Cbr>NP/MD on-call to begin  \u003Cbr>therapy until patient can  \u003Cbr>be seen.   | ▶ Current TSH,Total or   |\n| --- | --- |\n\n Free T4  \n▶All clinical notes and laboratory  \n● Known or treated child with  \nresults including growth chart  \nabnormal thyroid function  \ntest  \nClinical Findings  \n● Elevated TSH  \n● Low Total T4 or Free T4  \n## 3)Central Hypothyroidism [ICD-9 Code:253.4]\n\n2a)Acquired Hypothyroidism [ICD-9 Code:244.8]  \n## 2b)Autoimmune Thyroiditis/Hypothyroidism [ICD-9 Code:245.2]\n\nReferral Timeframe  \n▶First availableappointment,but call theNP/MD on-call to begintherapy until patient canbe seen  \n# Pediatric Endocrinology Referral Guidelines\n\n## Pre-Referral Workup\n\n▶ Current TSH,Total T4 or Free T4,Anti-Thyroglobulin Antibody and Anti-TPOAntibody  \n▶If TSH is abnormal but\u003C10 uU/ml and theTotal T4 or Free T4 are normal,obtainthyroid antibodies and repeat the TSH,Total T4 or Free T4 in 2-3 months.If TSHrising and antibodies are positive,refer  \n▶Thyroid ultrasound is unnecessary unlessthe gland is asymmetric or nodules arepalpable  \n\n| Clinical Findings   | Referral Timeframe   | Pre-Referral Workup   | Referral Requirements   |\n| --- | --- | --- | --- |\n| ● Low to Low normal TSH with  \u003Cbr>low Total T4 or Free T4  \u003Cbr>● History of traumatic brain  \u003Cbr>injury,midline facial  \u003Cbr>defects,brain irradiation,  \u003Cbr>hypoxic brain injury   | ▶URGENT:  \u003Cbr>Call NP/MD on-call to discuss and start  \u003Cbr>treatment.  \u003Cbr>On-Call Phone\\#  \u003Cbr>Day:  \u003Cbr>(312)996-1795  \u003Cbr>After Hours:  \u003Cbr>312-649-2639  \u003Cbr>▶After discussion with NP/MD on-call,may  \u003Cbr>be asked to obtain MRI of the brain and  \u003Cbr>pituitary with and without contrast   | ▶ Confirmatory TSH,Total T4  \u003Cbr>or Free T4  \u003Cbr>▶ Consider repeat of labs prior  \u003Cbr>to referral to assure validity   | ▶All clinical notes and laboratory  \u003Cbr>records including growth chart   |\n|  |  |  |  |\n|  |  |  |  |\n|  |  |  |  |\n|  |  ","cbCaicWqB8VCTceH","https://ap.wps.com/l/cbCaicWqB8VCTceH","pdf",3281700,"English","# Pediatric Endocrinology Referral Guidelines\n## Pre-Referral Workup\n## Clinical Findings\n## Referral Requirements\n## Urgent Referral Criteria","Pediatric Endocrinology Referral Guidelines - Key Facts | PDF",1790472946]