Download Diabetes Mellitus in ICD‐10‐CM

ICD‐10Resource:
DiabetesMellitusinICD‐10‐CM
ThediabetesmellituscodesareexpandedinICD‐10‐CM.Thecodesfordiabetesmellitus
arelocatedinchapter4,Endocrine,Nutritional,andMetabolicDiseases,inICD‐10‐CM.
UnlikeICD‐9‐CM,thecodesinICD‐10‐CMfordiabetesarecombinationcodesthatinclude
thetypeofdiabetesmellitus,thebodysystemaffected,andthecomplicationsofthatbody
system.TherearefivecategoriesfordiabetescodesinICD‐10‐CM:
E08
Diabetesmellitusduetoanunderlyingcondition
E09 Drugorchemicalinduceddiabetesmellitus
E10
Type1diabetesmellitus
E11
Type2diabetesmellitus
E13
Otherspecifieddiabetesmellitus
Asmanycodesasneededtoidentifyalloftheassociatedconditionsofthepatientsshould
beassigned.
Theterms“uncontrolled”and“notstatedasuncontrolled”arenolongerusedinICD‐10‐
CM.Insteadthecodesdescriptorsindicate“withcomplications”orwithoutcomplications.”
Thesubcategoriesforthecomplicationswiththebodysystemsaffectedbydiabetes
mellitusareasfollows:
 Ketoacidosis
o Withoutcoma
o Withcoma
 Kidneycomplications
o Diabeticnephropathy
o Diabeticchronickidneydisease
o Otherdiabetickidneycomplications
Copyright 2014 AAPC2480 South 3850 West Suite B, Salt Lake City, Utah 84120 
Ophthalmiccomplications
o Diabeticretinopathy
 Mildnonproliferativewith/withoutmacularedema
 Moderatenonproliferativewith/withoutmacularedema
 Severenonproliferativewith/withoutmacularedema
 Proliferativewith/withoutmacularedema
o Diabeticcataract
o Otherdiabeticophthalmiccomplications

Neurologicalcomplications
o Diabeticneuropathy
 Diabeticmononeuropathy
 Diabeticpolyneuropathy
 Diabeticautonomic(poly)neuropathy
o Diabeticamyotrophy
o Otherdiabeticneurologicalcomplications

Circulatorycomplications
o Diabeticperipheralangiopathywith/withoutgangrene
o Othercirculatorycomplications
Otherspecifiedcomplications
o Diabeticarthropathy
 Diabeticneuropathicarthropathy
 Otherdiabeticarthropathy
o Skincomplications
 Diabeticdermatitis
 Footulcer
 Otherskinulcer
 Otherskincomplication
o Oralcomplications
 Periodontaldisease
 Otheroralcomplications
o Hypoglycemia
 Withcoma
 Withoutcoma
o Hyperglycemia
o Otherspecifiedcomplication

Copyright 2014 AAPC2480 South 3850 West Suite B, Salt Lake City, Utah 84120 ImportantDiabetesMellitusGuidelines(completeguidelineslocatedintheICD‐10‐CM
codebook)
Typeofdiabetes:Theageofapatientisnotthesoledeterminingfactor,thoughmosttype
1diabeticsdeveloptheconditionbeforereachingpuberty.Forthisreasontype1diabetes
mellitusisalsoreferredtoasjuvenilediabetes.
Typeofdiabetesmellitusnotdocumented:Ifthetypeofdiabetesmellitusisnot
documentedinthemedicalrecordthedefaultiscategoryE11,Type2diabetesmellitus.
Forexample,ifthechargeticketstates“DM”thencodeE11.9,Type2diabetesmellitus
withoutcomplications,isthecodethatmustbeassigned.Itisveryimportantforproviders
toconsistentlydocumentthetypeofdiabetesinordertoreportthepropercode(s).
Diabetesmellitusandtheuseofinsulin:Ifthedocumentationinamedicalrecorddoes
notindicatethetypeofdiabetesbutdoesindicatethatthepatientusesinsulin,codeE11‐,
Type2diabetesmellitus,shouldbeassigned.CodeZ79.4,Long‐term(current)useofinsulin,
shouldalsobeassignedtoindicatethatthepatientusesinsulin.CodeZ79.4shouldnotbe
assignedifinsulinisgiventemporarilytobringatype2patient’sbloodsugarundercontrol
duringanencounter.
Example:
Atype2diabeticpatientthathasbeenusingLantusfor3monthstohelpcontrolhis
diabetespresentsforarecheck.Afterhistoryandexamination,itisdecidedtohavethe
patientcontinuetousetheLantusandcomebackin3months.AnA1cwillbeperformed
beforethenextvisit.
E11.9Type2diabetesmellituswithoutcomplications
Z79.4Long‐term(current)useofinsulin
IntheTableofDrugsandChemicalsinICD‐10‐CM,anewcolumnhasbeenaddedfor
underdosingofmedications.Thishasleadtonewguidelinesregardinginsulinpump
malfunction.
Underdoseofinsulinduetoinsulinpumpfailure:Anunderdoseofinsulinduetoan
insulinpumpfailureshouldbeassignedtoacodefromsubcategoryT85.6,Mechanical
complicationofotherspecifiedinternalandexternalprostheticdevices,implantsandgrafts,
thatspecifiesthetypeofpumpmalfunction,astheprincipalorfirst‐listedcode,followedby
codeT38.3X6‐,Underdosingofinsulinandoralhypoglycemic(antidiabetic)drugs.
Additionalcodesforthetypeofdiabetesmellitusandanyassociatedcomplicationsdueto
theunderdosingshouldalsobeassigned.
Overdoseofinsulinduetoinsulinpumpfailure:Theprincipalorfirst‐listedcodeforan
encounterduetoaninsulinpumpmalfunctionresultinginanoverdoseofinsulin,should
alsobeT85.6‐,Mechanicalcomplicationofotherspecifiedinternalandexternalprosthetic
Copyright 2014 AAPC2480 South 3850 West Suite B, Salt Lake City, Utah 84120 devices,implantsandgrafts,followedbycodeT38.3X1‐Poisoningbyinsulinandoral
hypoglycemic(antidiabetic)drugs,accidental(unintentional).
Example1:
Atype1diabeticpatientisbroughtintheemergencydepartmentwithaninsulinpump
breakdown,resultinginanunderdoseofinsulin.Thepatientisnowhasdiabetic
ketoacidosiswithcoma.
T85.614ABreakdown(mechanical)ofinsulinpump,initialencounter
T38.3X6AUnderdosingofinsulinandoralhypoglycemic(antidiabetic)drugs,initial
encounter
E10.11Type1diabetesmellituswithketoacidosiswithcoma
Example2:
Atype1diabeticpatientisbroughtintotheemergencydepartmentwithaninsulinpump
breakdown,resultinginanaccidentaloverdosingofinsulin.Thepatientisnowina
hypoglycemiccoma.
T85.614ABreakdown(mechanical)ofinsulinpump,initialencounter
T38.3X1APoisoningbyinsulinandoralhypoglycemic(antidiabetic)drugs,
accidental(unintentional),initialencounter
E10.641Type1diabetesmellituswithhypoglycemiawithcoma
Secondarydiabetesmellitus:CodesundercategoryE08Diabetesmellitusdueto
underlyingcondition,E09Drugorchemicalinduceddiabetesmellitus,andE13Other
specifieddiabetesmellitus,identifycomplications/manifestationsassociatedwith
secondarydiabetesmellitus.Secondarydiabetesmellitusisalwayscausedbyanother
conditionorevent(eg,cysticfibrosis,malignantneoplasmofpancreas,pancreatectomy,
adverseeffectofdrug,orpoisoning).
Assigningandsequencingsecondarydiabetescodesanditscauses:Thesequencingof
thesecondarydiabetesodesinrelationshiptocodesforthecauseofthediabetesisbased
ontheTabularListinstructionsforcategoriesE08,E09,andE13.
Secondarydiabetesmellitusduetopancreatectomy:Forpostpancreatectomydiabetes
mellitus(lackofinsulinduetothesurgicalremovalofallorpartofthepancreas),assign
codeE89.1Postproceduralhypoinsulinemia.AssignacodefromcategoryE13andacode
fromsubcategoryZ90.41‐Acquiredabsenceofpancreas,asadditionalcodes.
Secondarydiabetesduetodrugs:Secondarydiabetesmaybecausedbyanadverseeffect
ofcorrectlyadministeredmedications,poisoningorsequelaofpoisoning.
Copyright 2014 AAPC2480 South 3850 West Suite B, Salt Lake City, Utah 84120 Example:
Apatientpresentsforacheckup.Shedevelopeddiabetesafterapartialpancreatectomy.
Sheisdoingwellwithnoparticularcomplaints.
E89.1Postproceduralhypoinsulinemia
E13.9Otherspecifieddiabetesmellituswithoutcomplications
Z90.411Acquiredpartialabsenceofpancreas
Copyright 2014 AAPC2480 South 3850 West Suite B, Salt Lake City, Utah 84120