Borderline diabetes, also known as prediabetes, is the initial stage of type 2 diabetes. A person is said to suffer from this condition if his blood sugar level is higher than normal; but, not as high as found in case of diabetes. Improper lifestyle and eating habits are the major causes of it.
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:
Diagnosis Index entries containing back-references to R73.03:Borderline. diabetes mellitus R73.03.Diabetes, diabetic (mellitus) (sugar) E11.9. ICD-10-CM Diagnosis Code E11.9. Type 2 diabetes mellitus without complications. ... Prediabetes, prediabetic R73.03.
Because there are specific index entries for borderline diabetes and hypertension, codes R73. 09 (other abnormal glucose) and R03.
In ICD-9, prediabetes falls under 790.29: “Other abnormal blood glucose.” Sharing this diagnosis include hypoglycemia, hyperglycemia due to steroids, prediabetes, and over 20 other symptoms.
Its corresponding ICD-9 code is 250. Code I10 is the diagnosis code used for Type 2 Diabetes Mellitus. It is a disease in which the body does not control the amount of glucose (a type of sugar) in the blood and the kidneys make large amounts of urine.
Borderline diabetes, also called prediabetes, is a condition that develops before a person gets type 2 diabetes. It's also known as impaired fasting glucose or glucose intolerance. It basically means your blood sugar levels are higher than normal, but they're not quite high enough to be considered a sign of diabetes.
If the provider documents a "borderline" diagnosis at the time of discharge, the diagnosis is coded as confirmed, unless the classification provides a specific entry (e.g., borderline diabetes). If a borderline condition has a specific index entry in ICD-10-CM, it should be coded as such.
You would assign ICD-10 code Z13. 1, Encounter for screening for diabetes mellitus. This code can be found under “Screening” in the Alphabetical Index of the ICD-10 book.
This NCD lists the ICD-10 codes for HbA1c for frequencies up to once every three months. The ICD-10-CM codes for test frequencies exceeding one every 90 days are listed below. E08. 319 Diabetes mellitus due to underlying condition with unspecified diabetic retinopathy without macular edema E08.
“HbA1c may be used for the diagnosis of diabetes, with values >6.5% being diagnostic.
ICD-10 code: E11. 9 Type 2 diabetes mellitus Without complications.
8: Type 2 diabetes mellitus With unspecified complications.
E11. 69 - Type 2 diabetes mellitus with other specified complication. ICD-10-CM.
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.