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:
Prediabetes
The ICD-10 code for prediabetes is R73. 09.
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.
“R70-79” correspond to, “abnormal findings on examination of blood, without diagnosis.” The “73” indicates, “Elevated blood glucose level.” The “. 03” indicates, “Prediabetes.”
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.
A diagnosis that is documented as “borderline” at the time of discharge is coded as a confirmed diagnosis, unless there is a specific index entry in ICD-10-CM for a borderline condition.
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.
Fasting blood sugar test Less than 100 mg/dL (5.6 mmol/L ) is normal. 100 to 125 mg/dL (5.6 to 6.9 mmol/L ) is diagnosed as prediabetes. 126 mg/dL (7.0 mmol/L ) or higher on two separate tests is diagnosed as diabetes.
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.
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.
What are Prediabetes and Diabetes? Having prediabetes means your blood glucose (sugar) levels are higher than normal—but not high enough to be diagnosed as diabetes. Prediabetes can lead to heart disease, stroke, and type 2 diabetes, the most common form of diabetes. Prediabetes can often be reversed.
What Is A Borderline A1C Level? Your doctor can use the results of an A1C test to diagnose borderline diabetes. A “normal” A1C level is under 5.7%. In prediabetes, A1C is higher than normal (5.7 to 6.4%). You can be diagnosed with diabetes if your A1C is higher than than 6.5%.
If you have prediabetes, your blood sugar levels are higher than normal, but not high enough for you to be diagnosed with type 2 diabetes. Other names for prediabetes include: Borderline diabetes. Hyperglycemia, which means “high blood sugar”
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.