The ICD-10-CM is a catalog of diagnosis codes used by medical professionals for medical coding and reporting in health care settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates.
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:
Why ICD-10 codes are important
Prediabetes
E11. 22, Type 2 diabetes mellitus with diabetic CKD.
Diabetic nephropathy is a serious complication of type 1 diabetes and type 2 diabetes. It's also called diabetic kidney disease. In the United States, about 1 in 3 people living with diabetes have diabetic nephropathy.
Microvascular changes within the kidney often lead to chronic kidney disease (CKD), an entity referred to as diabetic kidney disease (DKD) or diabetic nephropathy6.
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.
Diabetic kidney disease is a type of kidney disease caused by diabetes. Diabetes is the leading cause of kidney disease. About 1 out of 3 adults with diabetes has kidney disease. 1. The main job of the kidneys is to filter wastes and extra water out of your blood to make urine.
Incipient nephropathy is the initial presence of low but abnormal amounts of urine albumin, referred to as microalbuminuria (persistent albuminuria at level 30–299 mg/24 hours).
Diabetes is the leading cause of chronic kidney disease.
Screening for microalbuminuria with a spot urine albumin/creatinine ratio identifies the early stages of nephropathy. Positive results on two of three tests (30 to 300 mg of albumin per g of creatinine) in a six-month period meet the diagnostic criteria for diabetic nephropathy.
Nondiabetic renal disease (NDRD) is seen as a cause of proteinuria and renal failure in type 2 diabetes mellitus (DM). The clinical differences between NDRD and diabetic glomerulosclerosis (DGS) are not clear.
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.
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.
So yes, use the appropriate combination codes, being E11. 22, I12. 9 and N18. 3.
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 “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.
In the next related question, the patient has acute pyelonephritis and nephrolithiasis, and the advice is to use two codes: N10, Acute pyelonephritis, and N 20.0, Calculus of kidney.
Chronic kidney disease (CKD) is often multifactorial, and the combination of diabetes and hypertension often leads to CKD. In fact, control of blood pressure in the presence of diabetes is considered more important than glycemic control (see Diabetic Kidney Disease: Chronic Kidney Disease and Diabetes, by Jerry Yee, ...
It is true you wouldn’t code both. Diabetic nephropathy is a specific subset of CKD. It is an advanced renal disease due to microvascular damage from hyperglycemia, manifested by proteinuria. I again refer you to the article referenced above; diabetic kidney disease includes diabetic nephropathy and other parenchymal kidney diseases, ...
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.
The ICD-10-CM coding guidelines established by the National Center for Health Care (NCHC) and the Centers for Medicare & Medicaid Services (CMS) for ICD-10-CM assist healthcare professionals and medical coders in selecting the appropriate diagnosis codes to report for a specific patient encounter.
The pancreas responds by making more insulin to try and manage the hyperglycemia , but eventually, the pancreas can’t keep up and blood sugar levels rise. Left uncontrolled, the disease progresses into prediabetes and, eventually, type 2 diabetes.
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.
The guidelines state that if the type of diabetes is not documented, the default is type 2. The guidelines also instruct to use additional codes to identify long-term control with insulin (Z79.4) or oral hypoglycemic drugs (Z79.84). You would not assign these codes for short-term use of insulin or oral medications to bring down a patient’s blood ...
This is called insulin resistance, which causes high blood sugar levels (hyperglycemia).
The longer someone has diabetes, and the less controlled their blood sugar is, the higher their risk of serious health complications, including: Cardiovascular disease . Kidney damage ( nephropathy)