Type 2 diabetes mellitus with diabetic neuropathy, unspecified
In ICD-10-CM, chapter 4, "Endocrine, nutritional and metabolic diseases (E00-E89)," includes a separate subchapter (block), Diabetes mellitus E08-E13, with the categories:
What Are the Most Common Causes of Neuropathic Pain?
limbs amputated due to peripheral neuropathy caused by the disease.”. If either peripheral or autonomic neuropathy is caused by diabetes, then a code from subcategory 250.6 will be sequenced first followed by code 357.2 for polyneuropathy in diabetes or code 337.1 for peripheral autonomic neuropathy.
ICD-9-CM Coding If either peripheral or autonomic neuropathy is caused by diabetes, then a code from subcategory 250.6 will be sequenced first followed by code 357.2 for polyneuropathy in diabetes or code 337.1 for peripheral autonomic neuropathy.
Peripheral Neuropathy.Proximal Neuropathy.Autonomic Neuropathy.Focal Neuropathy.
If you look in the alphabetical index under diabetes/diabetic with neuropathy it is E11. 40 (type 2 DM with diabetic neuropathy, unspecified). You cannot go with E11. 42 because that is specifically with polyneuropathy which is not documented.
Proximal neuropathy (diabetic polyradiculopathy) Unlike peripheral neuropathy, which affects the ends of nerves in the feet, legs, hands and arms, proximal neuropathy affects nerves in the thighs, hips, buttocks or legs. This condition is more common in people who have type 2 diabetes and in older adults.
There are various types of neuropathy depending on what nerves are damaged, compressed or defective. Peripheral neuropathy is the most common, but there is also proximal, cranial, autonomic and focal neuropathy.
Diabetic neuropathy is a type of nerve damage that can occur if you have diabetes. High blood sugar (glucose) can injure nerves throughout the body. Diabetic neuropathy most often damages nerves in the legs and feet.
Type 1 diabetes mellitus with diabetic polyneuropathy E10. 42 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E10. 42 became effective on October 1, 2021.
21 and E11. 22 have an excludes 1 notes therefore they can be coded together as long as a separate renal manifestation is present, I would just be careful when coding the actual renal condition as there are some renal codes that are excluded when using CKD codes.
Coding Diabetes Mellitus in ICD-10-CM: Improved Coding for Diabetes Mellitus Complements Present Medical ScienceE08, Diabetes mellitus due to underlying condition.E09, Drug or chemical induced diabetes mellitus.E10, Type 1 diabetes mellitus.E11, Type 2 diabetes mellitus.E13, Other specified diabetes mellitus.
Hereditary and idiopathic neuropathy, unspecified G60. 9 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM G60. 9 became effective on October 1, 2021.
Patients with diabetes can present with proximal neuropathy of the lower limbs, characterized by a variable degree of pain and sensory loss, associated with unilateral or bilateral proximal muscle weakness and atrophy.
In ICD-9, two codes were required to describe the complication: one for the type of diabetes and one for the complication. In ICD-10, diagnoses of diabetes are classified to one of five categories: E08 Diabetes mellitus due to underlying conditions; E09 Drug or chemical induced diabetes mellitus; E10 Type 1 diabetes mellitus;
Peripheral neuropathy may be the result of diabetes, traumatic injuries, infections, metabolic problems, and toxins, with diabetes being the most common cause. Symptoms Symptoms of peripheral neuropathy vary depending on the type of nerve affected.
Also, the description of the complications in ICD-10 are much more specific than in ICD-9. An example is diabetes with kidney complications. Two of the most commonly diagnosed kidney complications are chronic kidney disease (CKD) and diabetic nephropathy.
E11.42 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. This is the American ICD-10-CM version of E11.42 - other international versions of ICD-10 E11.42 may differ. Continue reading >>
As stated previously, in ICD-10, most diabetes codes do not require an additional code to describe the complication. However, there are a few exceptions. One exception is diabetes with CKD. Here, coding guidelines ask for the specific stage of CKD to be specified.
I'm pretty sure all of you who made it thus far in this article are familiar with the fact that there are at least two major types of diabetes: type I, or juvenile, and type II, with usual (though not mandatory) adult onset. Just like ICD-9, ICD-10 has different chapters for the different types of diabetes. The table below presents the major types of diabetes, by chapters, in both ICD coding versions. Diabetes Coding Comparison ICD-9-CM ICD-10-CM 249._ - Secondary diabetes mellitus E08._ - Diabetes mellitus due to underlying condition E09._ - Drug or chemical induced diabetes mellitus E13._ - Other specified diabetes mellitus 250._ - Diabetes mellitus E10._ - Type 1 diabetes mellitus E11._ - Type 2 diabetes mellitus 648._ - Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium O24._ - Gestational diabetes mellitus in pregnancy 775.1 - Neonatal diabetes mellitus P70.2 - Neonatal diabetes mellitus This coding structure for diabetes in ICD-10 is very important to understand and remember, as it is virtually always the starting point in assigning codes for all patient encounters seen and treated for diabetes. How To Code in ICD-10 For Diabetes 1. Determine Diabetes Category Again, "category" here refers to the four major groups above (not just to type 1 or 2 diabetes): E08 - Diabetes mellitus due to underlying condition E09 - Drug or chemical induced diabetes mellitus E10 - Type 1 diabetes mellitus E11 - Type 2 diabetes mellitus E13 - Other specified diabetes mellitus Note that, for some reason, E12 has been skipped. Instructions on Diabetes Categories Here are some basic instructions on how to code for each of the diabetes categories above: E08 - Diabetes mellitus due to underlying condition. Here, it is Continue reading >>
Detailed history of the patient like symptoms, lifestyle and exposure to toxins may also help to diagnose neuropathy. Blood tests, CT, MRI, electromyography, nerve biopsy and skin biopsy are the tests used to confirm neuropathy.
Autonomic neuropathy symptoms can be heart intolerance, excess sweat or no sweat, blood pressure changes, bladder, bowel or digestive problems. Physician does a thorough physical examination including extremity neurological exam and noting vitals.
Polyneuropathy – Two or more nerves in different areas get affected. Autonomic neuropathy – Affects the nerves which control blood pressure, sweating, digestion, heart rate, bowel and bladder emptying.
There is hereditary neuropathy also which get transferred from parent to child. Neuropathy can occur in any nerve of the body, but peripheral neuropathy is the common type seen in most of the people. As the name says peripheral neuropathy affects peripheral nerves usually extremities (hands and feet).
If yes, neuropathy and diabetes needs to be combined and coded regardless of it is polyneuropathy, autonomic neuropathy, mononeuropathy or unspecified neuropathy. Peripheral neuropathy with diabetes should be coded as E11.42 (DM with polyneuropath), not e11.40 (DM with neuropathy).