With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth.
Guidelines for Using ICD-10 Codes for Diabetes
As many ICD-10 codes as necessary can be used together to describe the patient’s form of diabetes. Pregnant women who are diabetic should be assigned a code from the 024 categories first, followed by the appropriate diabetes codes in the E08 to E13 range. For gestational diabetes (diabetes that occurs during pregnancy) women should be assigned a code under the 024.4 subheading and not any other codes under the 024 category.
If the type of diabetes that the patient has is not documented in the medical record, E11 codes for type 2 diabetes should be used as a default. If the medical record doesn’t say what type of diabetes the patient has but indicates that the patient uses insulin, the Type 2 diabetes codes should also be used.
The code for long-term use of insulin, Z79.4, should also be used in these cases (unless insulin was just given to the patient as a one-time fix to bring blood sugar under control).
Note that the word “with” in the code titles always means “associated with” or “due to” (it doesn’t refer to two disparate conditions). The “unspecified” codes can be used when not enough information is known to give a more specific diagnosis; in that case, “unspecified” is technically more accurate than a more specific but as yet unconfirmed diagnosis.
E11 Type 2 Diabetes Mellitus
ICD Code E11 is a non-billable code. To code a diagnosis of this type, you must use one of the eight child codes of E11 that describes the diagnosis ‘type 2 diabetes mellitus’ in more detail.
E11.0 Type 2 diabetes mellitus with hyperosmolarity
- E11.00 Type 2 diabetes mellitus with hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC)
- E11.01 Type 2 diabetes mellitus with hyperosmolarity with coma
E11.2 Type 2 diabetes mellitus with kidney complications
- E11.21 Type 2 diabetes mellitus with diabetic nephropathy
- E11.22 Type 2 diabetes mellitus with diabetic chronic kidney disease
- E11.29 Type 2 diabetes mellitus with other diabetic kidney complication
E11.3 Type 2 diabetes mellitus with ophthalmic complications
- E11.31 Type 2 diabetes mellitus with unspecified diabetic retinopathy
- E11.32 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy
- E11.33 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy
- E11.34 Type 2 diabetes mellitus with severe nonproliferative diabetic retinopathy
- E11.35 Type 2 diabetes mellitus with proliferative diabetic retinopathy
- E11.36 Type 2 diabetes mellitus with diabetic cataract
- E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication
E11.4 Type 2 diabetes mellitus with neurological complications
- E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified
- E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy
- E11.42 Type 2 diabetes mellitus with diabetic polyneuropathy
- E11.43 Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
- E11.44 Type 2 diabetes mellitus with diabetic amyotrophy
- E11.49 Type 2 diabetes mellitus with other diabetic neurological complication
E11.5 Type 2 diabetes mellitus with circulatory complications
- E11.51 Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene
- E11.52 Type 2 diabetes mellitus with diabetic peripheral angiopathy with gangrene
- E11.59 Type 2 diabetes mellitus with other circulatory complications
E11.6 Type 2 diabetes mellitus with other specified complications
- E11.61 Type 2 diabetes mellitus with diabetic arthropathy
- E11.62 Type 2 diabetes mellitus with skin complications
- E11.63 Type 2 diabetes mellitus with oral complications
- E11.64 Type 2 diabetes mellitus with hypoglycemia
- E11.65 Type 2 diabetes mellitus with hyperglycemia
- E11.69 Type 2 diabetes mellitus with other specified complication
E11.8 Type 2 diabetes mellitus with unspecified complications
E11.9 Type 2 diabetes mellitus without complications
Hyperosmolar Hyperglycemic State (HHS)
Hyperosmolar hyperglycemic state (HHS) is a complication of diabetes mellitus (predominantly type 2) in which high blood sugars cause severe dehydration, increases in osmolarity (relative concentration of solute) and a high risk of complications, coma, and death. It is diagnosed with blood tests.
It is related to diabetic ketoacidosis (DKA), another complication of diabetes more often (but not exclusively) encountered in people with type 1 diabetes; they are differentiated with measurement of ketone bodies, organic molecules that are the underlying driver for DKA but are usually not detectable in HHS.
Coding for Diabetes Mellitus in ICD 10 is a challenging task and you need a certified coder who is must have experience in Diabetes coding to choosing the correct CPT and ICD codes. Hiring such an expert can add a big overhead cost to your practice.
To avoid this, you can take assistance from medical billing company like Medical Billers and Coders (MBC) who has such experts. With our assistance, you don’t have to worry about using exact Diabetes Mellitus codes.
To know more about our Diabetes Mellitus coding services you can contact us at 888-357-3226/info@medicalbillersandcoders.com
Reference:
FAQs:
1. What is ICD-10 Code E11?
ICD-10 Code E11 is used for Type 2 diabetes mellitus. It covers different complications like kidney, ophthalmic, or circulatory issues.
2. What code should be used if the type of diabetes is unknown?
If the diabetes type is not documented, use E11 for Type 2 diabetes as the default.
3. How are diabetes codes assigned for pregnant women?
Pregnant women with diabetes should be assigned a code from the O24 category, followed by relevant diabetes codes (E08-E13).
4. What code is used for long-term insulin use?
Use Z79.4 for long-term insulin use, unless insulin is given temporarily to control blood sugar.
5. Can multiple ICD-10 codes be used for diabetes?
Yes, multiple codes can be used to describe the form and complications of diabetes accurately.
