us icd-10-cm code for: uncontrolled diabetes w/diabetic cataracts

by Eugenia Wilderman PhD 9 min read

ICD-10 code
ICD-10 code
ICD-10 is the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification list by the World Health Organization (WHO). › wiki › ICD-10
E11. 36 for Type 2 diabetes mellitus
Type 2 diabetes mellitus
Type 2 diabetes (T2D), formerly known as adult-onset diabetes, is a form of diabetes that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, and unexplained weight loss. › wiki › Type_2_diabetes
with diabetic cataract is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .

Full Answer

What are the consequences of uncontrolled diabetes?

What are the major complications of diabetes?

  • Eye problems (retinopathy) Some people with diabetes develop an eye disease called diabetic retinopathy which can affect their eyesight. ...
  • Foot problems Diabetes foot problems are serious and can lead to amputation if untreated. ...
  • Heart attack and stroke When you have diabetes, high blood sugar for a period of time can damage your blood vessels. ...

More items...

What are the symptoms of uncontrolled diabetes?

Uncontrolled diabetes means your blood sugar levels are too high, even if you're treating it. And you may have symptoms such as peeing more often, being thirsty a lot, and having other problems ...

What is ICD 10 for poorly controlled diabetes?

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:

  • E08, 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

How to code diabetes correctly?

Diabetes Mellitus and the Use of Insulin and Oral Hypoglycemic Drugs If the documentation in a medical record does not indicate the type of diabetes but does indicate that the patient uses insulin: Assign code E11-, Type 2 diabetes mellitus. Assign code Z79.4, Long term (current) use of insulin, or Z79.84, Long-term (current) use of oral

What is the ICD-10-CM code for type 1 diabetes mellitus with diabetic cataracts?

Type 1 diabetes mellitus with diabetic cataract E10. 36 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E10. 36 became effective on October 1, 2021.

Is there an assumed relationship between diabetes and cataract?

Diabetes is one of the key factors that result in the development of cataracts. Although the reasons why are still not fully understood, people with diabetes mellitus statistically face a 60% greater risk of developing cataracts.

What is the ICD-10 code for diabetes uncontrolled?

ICD-10 code E11. 65 represents the appropriate diagnosis code for uncontrolled type 2 diabetes without complications.

What is diabetic cataract?

Cataract in diabetic patients is a major cause of blindness in developed and developing countries. The pathogenesis of diabetic cataract development is still not fully understood. Recent basic research studies have emphasized the role of the polyol pathway in the initiation of the disease process.

Which of the following is the first code for a diagnosis of diabetic cataract?

Type 2 diabetes mellitus with diabetic cataract E11. 36 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2022 edition of ICD-10-CM E11. 36 became effective on October 1, 2021.

Can you have cataract surgery if you have type 2 diabetes?

Cataract surgery is a common and safe procedure, but can be associated with vision-threatening complications in the diabetic population, such as diabetic macular edema, postoperative macular edema, diabetic retinopathy progression, and posterior capsular opacification.

What is the ICD-10 code for diabetes type 2 uncontrolled?

ICD-10 code E11. 65 for Type 2 diabetes mellitus with hyperglycemia is a medical classification as listed by WHO under the range - Endocrine, nutritional and metabolic diseases .

What is controlled vs uncontrolled diabetes?

Based on the levels of Glycosylated Haemoglobin (HbA1c) in the blood, American Diabetic Association has classified Type-2 Diabetes Mellitus patients as uncontrolled group of diabetic patients whose HbA1c level is maintained more than 7% and as controlled group of diabetic patients whose HbA1c level is maintained less ...

What is the difference between E11 21 and E11 22?

E11. 22 states within its code DM with CKD therefore it is a more accurate code than E11. 21 which is just DM with Nephropathy (any kidney condition).

Can uncontrolled diabetes cause cataracts?

When you have diabetes, high blood sugar (blood glucose) levels over time can lead to structural changes in the lens of the eye that can accelerate the development of cataracts.

Is cataract a complication of diabetes?

If left unchecked, high blood sugar slowly damages blood vessels throughout the body. This includes the tiny blood vessels in the eyes. And when diabetes affects these blood vessels, there's the risk of cataracts and other eye conditions. Cataracts are the result of high sugar levels in the aqueous humor.

What are the 3 types of cataracts?

There are three primary types of cataracts: nuclear sclerotic, cortical and posterior subcapsular.Nuclear Sclerotic Cataracts. ... Cortical Cataracts. ... Posterior Subcapsular Cataracts.

What is the correct ICD-9 code for diabetes mellitus?

Most coders can quickly come up with 250.00. And if the physician only documented diabetes mellitus , that’s the correct ICD-9-CM code. If a physician doesn’t document complications or type of diabetes, coders default to code 250.00 (diabetes mellitus without mention of complications), says Jill Young, CPC, CEDC, CIMC, president of Young Medical Consulting, LLC, in East Lansing, MI. However, 250.00 is not necessarily the best code to describe the patient’s actual condition. Consider these two patients. Patient A is a type 2 diabetic with well controlled diabetes. Patient B is a type 2 diabetic with uncontrolled diabetes who also suffers from diabetes-related chronic kidney disease. If the physician documents “diabetes mellitus” for both patients, coders would report the same code, even though the patients have very different conditions. The physician loses reimbursement on Patient B, who is sicker and requires more care, Young says. Coding in ICD-9-CM When it comes to the code assignment for diabetes mellitus in ICD-9-CM (250 code series), coders identify whether the diabetes is type 1or 2 using a fifth digit, says Shannon E. McCall, RHIA, CCS, CCS-P, CPC, CPC-I, CEMC, CCDS, director of HIM/coding for HCPro, Inc., in Danvers, Mass, and an AHIMA-approved ICD-10-CM/PCS trainer. If the diabetes is secondary, coders choose from codes in the 249 series. Under series 250, coders will find 10 different subcategories that further define and refine the patient’s actual condition. All of those codes require a fifth digit to indicate whether the diabetes is controlled or uncontrolled, type 1or type 2. The fifth digit subclassifications are: Coders also need to note that codes 250.4, 250.5, 250.6, 250.7, and 250.8 all include instructions to use an additional code to ide Continue reading >>

What is diabetes mellitus?

A heterogeneous group of disorders characterized by hyperglycemia and glucose intolerance. A metabolic disorder characterized by abnormally high blood sugar levels due to diminished production of insulin or insulin resistance/desensitization. A subclass of diabetes mellitus that is not insulin-responsive or dependent (niddm). It is characterized initially by insulin resistance and hyperinsulinemia; and eventually by glucose intolerance; hyperglycemia; and overt diabetes. Type ii diabetes mellitus is no longer considered a disease exclusively found in adults. Patients seldom develop ketosis but often exhibit obesity. A type of diabetes mellitus that is characterized by insulin resistance or desensitization and increased blood glucose levels. This is a chronic disease that can develop gradually over the life of a patient and can be linked to both environmental factors and heredity. Diabetes is a disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood.over time, having too much glucose in your blood can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. Pregnant women can also get diabetes, called gestati Continue reading >>

Can diabetes cause heart disease?

It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb.

Is there more than one type of diabetes?

I'm pretty sure all of you who made it thus far in this article are familiar with the fact that there are at least two major types of diabetes: type I, or juvenile, and type II, with usual (though not mandatory) adult onset. Just like ICD-9, ICD-10 has different chapters for the different types of diabetes. The table below presents the major types of diabetes, by chapters, in both ICD coding versions. Diabetes Coding Comparison ICD-9-CM ICD-10-CM 249._ - Secondary diabetes mellitus E08._ - Diabetes mellitus due to underlying condition E09._ - Drug or chemical induced diabetes mellitus E13._ - Other specified diabetes mellitus 250._ - Diabetes mellitus E10._ - Type 1 diabetes mellitus E11._ - Type 2 diabetes mellitus 648._ - Diabetes mellitus of mother, complicating pregnancy, childbirth, or the puerperium O24._ - Gestational diabetes mellitus in pregnancy 775.1 - Neonatal diabetes mellitus P70.2 - Neonatal diabetes mellitus This coding structure for diabetes in ICD-10 is very important to understand and remember, as it is virtually always the starting point in assigning codes for all patient encounters seen and treated for diabetes. How To Code in ICD-10 For Diabetes 1. Determine Diabetes Category Again, "category" here refers to the four major groups above (not just to type 1 or 2 diabetes): E08 - 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 Note that, for some reason, E12 has been skipped. Instructions on Diabetes Categories Here are some basic instructions on how to code for each of the diabetes categories above: E08 - Diabetes mellitus due to underlying condition. Here, it is Continue reading >>

What is the ICD-10 code for diabetes?

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.

What type of diabetes codes should be used?

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.

When to use unspecified ICD-10?

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.

Why are cataracts a major cause of impairment in diabetic patients?

As previously published inc Coding Clinic, Fourth quarter 2016, cataracts are a major cause of impairment in diabetic patients as the incidence and progression is elevated due to the diabetes mellitus.

What is the word "with" in ICd 10?

In the alpha section under the keyword diabetes you see the word "with" the terms indented under the word with are considered to be automatic causal conditions. The provider does not need to document the causal relationship.

Can a diabetic have a senile cataract?

It states senile cataracts are more frequently seen in patients with diabetes, but they are not true diabetic cataracts. So, in your scenario you would code the unspecified cataract, or query the physician as to the type of cataract if you still are unclear.

Is a diabetic cataract rare?

It further states that cataracts in patients with diabetes are most often senile cataracts, and ..."a true diabetic cataract is rare, and its code should not be assigned unless the physician clearly identifies it as such.".

Can you code E11.8 DM?

diabetic cataract#N#If you have the ability to query your physician, please do that. Diabetes and cataract should clearly be linked together in order for you to report it. You can code E11.8 DM with complicatios. But as coders we need to code to the highest level of specificity.

Can you assign a code for diabetic cataract?

Answer: Yes it is appropriate to assign a code for diabetic ca taract, based on the relationship between diabetes and cataracts as linked conditions. Assign code E11.36, Type 2 diabetes mellitus with diabetic cataract.

What is the code for gestational diabetes?

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.

What is the default type of diabetes?

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 ...

How does the pancreas respond to hyperglycemia?

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.

What is secondary 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.

What is the cause of high blood sugar levels in type 2 diabetics?

This is called insulin resistance, which causes high blood sugar levels (hyperglycemia).

What are the complications of chronic 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)

What is the ICd 10 code?

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.