Prediabetes
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:
icd 10 diabetes insipidus Insulin. Insulin is a hormone that allows glucose (sugar) – the body’s main fuel – to enter the cells and to be used for energy. Insulin can’t be taken orally because your stomach will digest it. It’s given as an injection using a small needle just under the skin. The places to inject are usually the thighs, buttocks and abdomen (belly).
The incorrect portion of the response came as an aside at the end, where it was stated that “it would be redundant to assign codes for both diabetic nephropathy (E11. 21) and diabetic chronic kidney disease (E11. 22), as diabetic chronic kidney disease is a more specific condition.” It is true you wouldn't code both.
ICD-10-CM Code for Type 2 diabetes mellitus with diabetic nephropathy E11. 21.
E11. 22, Type 2 diabetes mellitus with diabetic CKD. I12. 9, hypertensive CKD with stage 1 through 4 CKD, or unspecified CKD.
Diabetes also can cause progressive scarring of glomeruli. This is called glomerulosclerosis. This scarring often produces nodules (lumps) of scar in the glomeruli and thus is called nodular diabetic glomerulosclerosis.
DEFINITION The term "triopathy" has been applied to diabetic patients who usually have shown, first, clinical evidence of neuropathy; then, diabetic retinitis, and, finally, the nephropathy of diabetes. In this series, the. 1. Root, H. F., and Kenney, A. J., in Joslin and others.1. 2.
What is diabetic nephropathy? Nephropathy is the deterioration of kidney function. The final stage of nephropathy is called kidney failure, end-stage renal disease, or ESRD. According to the CDC, diabetes is the most common cause of ESRD.
Per our recent Humana audit, it was indicated that diabetes and hypertension have an assumed relationship and it should be coded as E11. 59 (for type 2 diabetic.)
E11. 22 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes.
ICD-10 requires first using an I12 code for the combined diagnosis of hypertension and chronic kidney disease: I12. 0, Hypertensive chronic kidney disease with stage 5 chronic kidney disease or end- stage renal disease, I12.
Microalbuminuria refers to a higher-than-normal amount of albumin in the urine. A high value of this urinary protein may indicate a problem with the kidneys. As people with diabetes have an increased risk of kidney complications, a doctor may request a microalbuminuria test to help detect early signs of kidney disease.
Focal segmental glomerulosclerosis can be caused by a variety of conditions, such as diabetes, sickle cell disease, other kidney diseases and obesity. It can also be caused by an infection and drug toxicity. A rare form of FSGS is caused by inherited abnormal genes. Sometimes there's no identifiable cause.
In diffuse diabetic glomerulosclerosis, there is diffuse thickening of the glomerular basement membrane (GBM; fig 2B), which early in the disease process cannot be appreciated by light microscopy. As the disease progresses, the mesangial matrix continues to accumulate, along with mesangial cells.
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.
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).
ICD-10 codes refer to the codes from the 10th Revision of the classification system. ICD-10 officially replaced ICD-9 in the US in October of 2015.
The switch to ICD-10 was a response to the need for doctors to record more specific and accurate diagnoses based on the most recent advancements in medicine. For this reason, there are five times more ICD-10 codes than there were ICD-9 codes. The ICD-10 codes consist of three to seven characters that may contain both letters and numbers.
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. For more guidelines on using ICD-10 codes for diabetes mellitus, you can consult this document.
The more characters in the code, the more specific the diagnosis, so when writing a code on a medical record you should give the longest code possible while retaining accuracy.
Here's a conversion table that translates the old ICD-9 codes for diabetes to ICD-10 codes. There weren’t as many codes to describe different conditions in the ICD-9, so you’ll notice that some of them have more than one possible corresponding ICD-10 code. Some are also translated into a combination of two ICD-10 codes (note the use of the word "and").
E10.29 Type 1 diabetes mellitus with other diabetic ...
E11.618 Type 2 diabetes mellitus with other diabetic ...
These include drug- or chemical-induced diabetes mellitus (E09.-); gestational diabetes (Q24.4-); neonatal diabetes mellitus (P70.2); and postpancreatectomy, postprocedural, or secondary diabetes mellitus (E13.-).
Finding the ICD-10 codes for diabetic retinopathy can be tricky. They are not listed in Chapter 7, Diseases of the Eye and Adnexa (H00-H59), but are in the diabetes section (E08-E13) of Chapter 4, Endocrine, Nutritional and Metabolic Diseases.
Instead, diabetes documentation should address the following questions: Is it type 1 or type 2? Is there diabetic retinopathy? If so, is it proliferative or nonproliferative? If nonproliferative, is it mild, moderate, or severe? Is there macular edema?
Follow the instructions in the Tabular List of ICD-10-CM for proper sequencing of these diagnosis codes. For example, if a patient has secondary diabetes as a result of Cushing’s syndrome and no other manifestations, report code E24.9 Cushing’s syndrome, unspecified, followed by E08.9 Diabetes mellitus due to underlying condition without manifestations. If a patient is diagnosed with secondary diabetes due to the adverse effects of steroids, report codes E09.9 Drug or chemical induced diabetes without complications and T38.0X5A Adverse effect of glucocorticoids and synthetic analogues, initial encounter.
Codes for gestational diabetes are in subcategory O24.4. These codes include treatment modality — diet alone, oral hypoglycemic drugs, insulin — so you do not need to use an additional code to specify medication management. Do not assign any other codes from category O24 with the O24.4 subcategory codes.
Report encounters related to pregnancy and diabetes using codes in Chapter 15 Pregnancy, Childbirth, and the Puerperium. If a pregnant woman has pre-existing diabetes that complicates the pregnancy, Chapter 15 guidelines instruct us to assign a code from O24 first, followed by the appropriate diabetes code (s) from Chapter 4 (E08–E13). Report codes Z79.4 or Z79.84 if applicable.
Secondary diabetes — DM that results as a consequence of another medical condition — is addressed in Chapter 4 guidelines. These codes, found under categories E08, E09, and E13, should be listed first, followed by the long-term therapy codes for insulin or oral hypoglycemic agents.
Type 1.5 diabetes is a form of diabetes in which an adult has features of both type 1 and type 2 diabetes. These patients have also been described with the terms “latent autoimmune diabetes of adults” (LADA), and “slow-progressing type 1 diabetes.” The condition has also been called “double” diabetes, because individuals demonstrate both the autoimmune destruction of beta cells of type 1 diabetes and the insulin resistance characteristic of type 2 diabetes. People with type 1.5 diabetes have autoantibodies to insulin-producing beta cells and gradually lose their insulin-producing capability, requiring insulin within 5–10 years of diagnosis.
Left uncontrolled, the disease progresses into prediabetes and, eventually, type 2 diabetes. This is the most common type of diabetes and is initially treated with lifestyle modification including a healthy diet and exercise. If these measures are not effective, treatment generally starts with an oral hypoglycemic agent.
If you look in the Alphabetic Index under E11.9 Diabetes/type 2/with, you’ll find codes that describe type 2 diabetes with amyotrophy (E11.44), arthropathy NEC (E11.618), autonomic (poly) neuropathy (E11.43), cataract (E11.36), Charcot’s joints (E11.610) , chronic kidney disease (E11 .22) , etc.