Resolved ICD E1142

[BonnieS_3528]

What do you need for DM 2 w/polyneurapathy E11.42?

 

[Lori]

ICD-10 Category E11* Diabetes Mellitus:

Tips on How to Code using ICD-10 Codes
Diabetes Mellitus is an HCC (Hierarchical Condition Category)

The diabetes mellitus codes are combination codes that include:

1. The type of diabetes mellitus
2. The body system(s) affected
3. The complications affecting the body system(s)

When coding diabetes mellitus, you should use as many codes from categories E08-E13* as necessary to describe all of the
complications and associated conditions of the disease.

These categories are listed below:

ICD-10 Code Category ICD-10 Description Note:

E08* Diabetes mellitus due to underlying condition Code first the underlying condition
Use additional code to identify any insulin use
E09* Drug or chemical induced diabetes mellitus Code first poisoning due to drug or toxin, if applicable
Use additional code for adverse effect, if applicable, to identify drug
Use additional code to identify any insulin use
E10* Type 1 diabetes mellitus No additional code needed to identify insulin use
E11* Type 2 diabetes mellitus Use additional code to identify any insulin use
E13* Other specified diabetes mellitus Use additional code to identify any insulin use


In order to link a manifestation/complication to diabetes mellitus, the documentation must clearly show that there is a causal effect
of the disease to the associated manifestation. A coder cannot assume that there is a causal relationship between two diagnoses.
One diagnosis code MUST be clearly documented in the medical record as being directly related to the other.

Examples: • Diabetic Nephropathy • CKD Due to DM • PVD Due to DM • PAD Due to DM • Diabetic Neuropathy
• Peripheral Neuropathy Due to DM • Etiology of Neuropathy is DM • Diabetic Retinopathy • Diabetic Cataract • Diabetic Macular Edema

ICD-10 Code Category ICD-10 Description Assign this code when:

E11.9 Type 2 Diabetes Mellitus without
complications
No complications are listed or documented as being directly related to
the disease

E11.8 Type 2 Diabetes Mellitus with unspecified
complications
The documentation states that there is a complication directly related to
the disease but no specific complication has been listed

E11.00-E11.65 Type 2 Diabetes Mellitus with specified
complications
The documentation clearly states that there is a complication directly
related to the disease and the specific complication has been clearly
documented

E11.69 Type 2 Diabetes Mellitus with other specified
complications
The documented complication is not one that has been listed in
the code range E11.00-E11.65. Also, you must use an additional code
to identify the specific complication

There can be more than one complication associated with diabetes mellitus. Use all applicable ICD-10 codes needed to accurately code a
patient’s condition. Also remember to add ICD-10 code Z79.4 (long-term current use of insulin), if applicable

https://providers.bcbsal.org/portal/documents/10226/306297/Correctly+Coding+Diabetes+Mellitus/cf5e3336-d1b7-4abb-aa17-b03b33e35d90

Read more here in the CCO Community:

Resource - Coding Diabetes

https://www.icd10monitor.com/coding-diabetes-time-to-look-at-the-coding-guidelines-again

www.cco.community