Understanding ICD-10 Code for Diabetes Type 2 and Care
What is Type 2 Diabetes?
Type 2 diabetes, also known as type 2 diabetes mellitus, is a chronic metabolic disorder where the body struggles with insulin resistance or insulin deficiency. This leads to high blood sugar levels or hyperglycemia. Over time, the pancreas may not produce enough insulin, or the body’s cells may not respond to insulin properly. Glucose cannot enter the cells to provide energy, causing various serious health complications, like affecting the heart, kidneys, eyes, and nerves. Most commonly diagnosed in adults, this condition, once called adult-onset diabetes, can also affect children and teens. It’s manageable through lifestyle changes like a healthy diet, regular exercise, and medication.
ICD 10 Code for Diabetes Type 2
The ICD-10 code E11 is used for type 2 diabetes mellitus and encompasses a wide code range to capture various subcategories of the disease, ensuring accurate documentation of complications and conditions. Additional digits and characters are added to the base code to provide more detail on whether the condition involves complications like hyperosmolarity or nephropathy. The ICD-10 system, implemented on October 1, 2015, replaced the older ICD-9 (the 9th Revision). E11 is the default code for type 2 diabetes if the medical record doesn’t specify the exact type.
Key Code Specifications:
- E11: General code for type 2 diabetes mellitus.
- E11.00: Hyperosmolarity without nonketotic hyperglycemic coma (NKHHC).
- E11.01: Hyperosmolarity with coma.
- E11.2: Kidney complications, such as diabetic nephropathy.
- E11.36: Diabetic cataract (ophthalmic complications).
- E11.65: Hyperglycemia as a complication.
- Z79.4: Long-term use of insulin for diabetes management.
For pregnant women diagnosed with gestational diabetes, the 024.4 code is assigned, distinct from other 024 categories. In cases where the patient’s type of diabetes is unclear, the E11 code should be used as a default. Insulin usage, documented in the record, is often paired with the Z79.4 code, unless insulin was used as a one-time fix to control blood sugar.
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Prediabetes and Its ICD-10 Code
- Prediabetes is when blood sugar levels are higher than normal but not yet high enough for type 2 diabetes. It’s a serious condition that increases the risk of heart disease, stroke, and kidney damage. The ICD 10 code for prediabetes is R73.03. While prediabetes doesn’t always lead to type 2 diabetes, without lifestyle changes, there’s a high risk for long-term damage. Early intervention can help prevent full progression.
Diabetes Type 2 with Hyperglycemia
The ICD-10 code E11.65 is used for diabetes type 2 when it involves hyperglycemia, a condition where blood sugar levels are too high. This occurs due to insulin resistance, where the body’s cells don’t respond well to insulin, or reduced insulin production by the pancreas. Symptoms like frequent urination, increased thirst, fatigue, and blurred vision are common. Factors such as stress, illness, certain medications, and poor management of a diabetes-friendly meal plan or exercise can worsen hyperglycemia. Effective diabetes management includes oral diabetes medications, insulin therapy, and improving insulin sensitivity with lifestyle changes.
Diabetes Type 2 with Complications
- Diabetes Type 2 can lead to serious health problems when blood sugar levels are not controlled, causing damage to various organs and systems. Identified by the diagnosis code E11.8, complications include cardiovascular disease, nerve damage (neuropathy), kidney damage (nephropathy), and eye problems (retinopathy). Specific codes like E11.2, E11.21, E11.22, and E11.29 cover kidney-related issues such as diabetic nephropathy and chronic kidney disease. Poor control may cause high blood pressure, atherosclerosis, dialysis needs, or even amputation. Issues like tingling, vision loss, and infections highlight the importance of managing this condition effectively.
Insulin-dependent Diabetes Type 2
In Type 2 diabetes, the body develops insulin resistance, and the pancreas may not produce sufficient insulin to meet the body’s demands. For patients requiring long-term insulin use, the ICD-10 code Z79.4 is applied to indicate insulin dependency associated with this condition.
Coding Guidelines for Diabetes Type 2
In Type 2 diabetes, the body develops insulin resistance, and the pancreas may not produce sufficient insulin to meet the body’s demands. For patients requiring long-term insulin use, the ICD-10 code Z79.4 is applied to indicate insulin dependency associated with this condition.
- E11.9: Used for unspecified Type 2 diabetes mellitus, particularly when the condition is well-controlled without complications.
- Z79.4: Indicates the long-term use of insulin or oral hypoglycemic drugs.
- E11.1 – E11.8: Refer to specific complications, such as diabetic retinopathy, nephropathy, neuropathy, and cardiovascular disease.
- E11.65: Applied for uncontrolled diabetes with hyperglycemia.
- E11.69: Covers Type 2 diabetes with other specified complications.
- E11.93: Represents unspecified diabetic retinopathy without macular oedema.
- E11.94: Used for unspecified diabetic retinopathy with macular oedema.
- E11.91: Specifies mild nonproliferative diabetic retinopathy with macular oedema in the right eye.
- E11.92: Denotes mild nonproliferative diabetic retinopathy with macular oedema in the left eye.
Child ICD 10 Codes for Type 2 Diabetes Mellitus
ICD 10 for Diabetes Mellitus Type 2 Due to Hyperosmolarity (E11.0)
| ICD-10 Code | Description |
|---|---|
| ICD E11.0 | Type 2 diabetes mellitus due to hyperosmolarity |
| ICD E11.00 | Hyperosmolarity without nonketotic hyperglycemic-hyperosmolar coma (NKHHC) |
| ICD E11.01 | Hyperosmolarity with coma |
ICD 10 for Type 2 diabetes mellitus with kidney complications (E11.2 series)
| ICD-10 Code | Description |
|---|---|
| ICD E11.21 | Type 2 diabetes mellitus with diabetic nephropathy |
| ICD E11.22 | Type 2 diabetes mellitus with diabetic chronic kidney disease |
| ICD E11.29 | Type 2 diabetes mellitus with other diabetic kidney complications |
ICD 10 for Type 2 diabetes mellitus with ophthalmic complications (E11.3 series)
| ICD-10 Code | Description |
|---|---|
| ICD E11.31 | Type 2 diabetes mellitus with unspecified diabetic retinopathy |
ICD 10 for Type 2 diabetes mellitus with neurological complications (E11.4 series)
| ICD-10 Code | Description |
|---|---|
| ICD E11.40 | Type 2 diabetes mellitus with diabetic neuropathy, unspecified |
| ICD E11.41 | Type 2 diabetes mellitus with diabetic mononeuropathy |
| ICD E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy |
| ICD E11.43 | Type 2 diabetes mellitus with diabetic autonomic neuropathy |
ICD 10 for diabetes mellitus with other specified complications (E11.6)
| ICD-10 Code | Description |
|---|---|
| ICD E11.62 | Type 2 diabetes mellitus with skin complications |
| ICD E11.63 | Type 2 diabetes mellitus with oral complications |
| ICD E11.64 | Type 2 diabetes mellitus with hypoglycemia |
| ICD E11.65 | Type 2 diabetes mellitus with hyperglycemia |
| ICD E11.8 | Type 2 diabetes mellitus with unspecified complications |
| ICD E11.9 | Type 2 diabetes mellitus without complications (including cases in children with no complications) |
Conclusion
Proper documentation and classification of Type 2 diabetes are essential for effective patient management, accurate research, and streamlined healthcare processes. The ICD 10 Code for Diabetes Type 2, particularly E11, ensures comprehensive recording of diagnoses and complications, including hyperglycemia (E11.65), nephropathy (E11.21), and retinopathy (E11.31). This globally recognised system supports medical professionals in monitoring blood sugar levels, managing risks, and improving outcomes. Through early detection and consistent use of the ICD-10 Code for Diabetes Type 2, healthcare providers can facilitate better treatment strategies, highlighting the importance of lifestyle adjustments like diet and exercise in preventing severe complications. Learn more about effective medical coding solutions at MedStates today!
