Hyperosmolar hyperglycemic syndrome is also known by many other names, including: Diabetes-related HHS. Diabetes-related hyperosmolar syndrome. Hyperglycemic hyperosmolar nonketotic coma (HHNK).
Overview. Diabetic hyperosmolar (hi-pur-oz-MOE-lur) syndrome is a serious condition caused by extremely high blood sugar levels. The condition most commonly occurs in people with type 2 diabetes. It's often triggered by illness or infection.
DKA is characterized by ketoacidosis and hyperglycemia, while HHS usually has more severe hyperglycemia but no ketoacidosis (table 1). Each represents an extreme in the spectrum of hyperglycemia. The precipitating factors, clinical features, evaluation, and diagnosis of DKA and HHS in adults will be reviewed here.
Hyperglycemic hyperosmolar nonketotic diabetic coma is characterized by elevated serum osmolality (> 330 mOsm/L) and elevated blood glucose level (> 600 mg/dL) with mild or no acidosis. Trauma or infection in type 2 diabetic patients usually leads to this state rather than to ketoacidosis.
The loss of water also makes the blood more concentrated than normal. This is called hyperosmolarity. It is a condition in which the blood has a high concentration of salt (sodium), glucose, and other substances. This draws the water out of the body's other organs, including the brain.
Hyperglycemic hyperosmolar nonketotic syndrome (HHNS) is a potentially deadly condition that can develop as a result of infection or illness in people with uncontrolled type 2 diabetes or when diabetes medications aren't taken as directed. Some also refer to this as a "diabetic coma."
Over 30% of patients have features of both DKA and HHS (16) with most recent evidence confirming that about 1 out of 4 patients will have both conditions at the time of presentation with hyperglycemic crisis (18).
Hyperosmolar hyperglycemic state (HHS) is one of two serious metabolic derangements that occur in patients with diabetes mellitus (DM). It is a life-threatening emergency that, although less common than its counterpart, diabetic ketoacidosis (DKA), has a much higher mortality rate, reaching up to 5-10%.
Hyperosmolar hyperglycemic state is a life-threatening emergency manifested by marked elevation of blood glucose and hyperosmolarity with little or no ketosis. Although there are multiple precipitating causes, underlying infections are the most common.
HHS is a potentially life-threatening emergency It does not usually lead to the presence of ketones in the urine, as occurs in diabetic ketoacidosis (DKA), which is why it was previously referred to as HONK (hyperglycaemic hyperosmolar non-ketotic coma).
Nursing home as the place of occurrence of the external cause 1 Y92.12 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. 2 Short description: Nursing home as place 3 The 2021 edition of ICD-10-CM Y92.12 became effective on October 1, 2020. 4 This is the American ICD-10-CM version of Y92.12 - other international versions of ICD-10 Y92.12 may differ.
The 2022 edition of ICD-10-CM Y92.12 became effective on October 1, 2021.
Y92.12 describes the circumstance causing an injury, not the nature of the injury. This chapter permits the classification of environmental events and circumstances as the cause of injury, and other adverse effects. Where a code from this section is applicable, it is intended that it shall be used secondary to a code from another chapter ...
Nursing home as the place of occurrence of the external cause. 2016 2017 2018 2019 2020 2021 Non-Billable/Non-Specific Code. Y92.12 should not be used for reimbursement purposes as there are multiple codes below it that contain a greater level of detail. Short description: Nursing home as place.
It will code to E11.00 the code indicates hyperosmolarity without coma it does not indicate without hyperosmolar nonketotic hyperglycemia so since the documentation indicated Type 2 diabetes mellitus with hyperosmolar nonketotic hyperglycemia, but did not state with coma then E11.00 is correct.
Note: All neoplasms, whether functionally active or not, are classified in Chapter 2. Appropriate codes in this chapter (i.e. E05.8, E07.0, E16-E31, E34.-) may be used as additional codes to indicate either functional activity by neoplasms and ectopic endocrine tissue or hyperfunction and hypofunction of endocrine glands associated with neoplasms and other conditions classified elsewhere.
Diabetes mellitus due to underlying condition with proliferative diabet ic retinopathy with traction retinal detachment involving the macula, right eye. E08.3522. Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with traction retinal detachment invol ving the macula, left eye.
Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, bilateral. E08.3519. Diabetes mellitus due to underlying condition with proliferative diabetic retinopathy with macular edema, unspecified eye.