Diabetes ICD-1Diabetes mellitus, often simply referred to as diabetes—is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin or because cells do not respond to the insulin that is produced. This high blood sugar produces the classic symptoms of polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).
Type 1 diabetes: results from the body’s failure to produce insulin and presently requires the person to inject insulin. (Also referred to as insulin-dependent diabetes mellitus, IDDM for short, and juvenile diabetes.)
Type 1 diabetes mellitus is characterized by the loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas leading to insulin deficiency.
Type 2 diabetes: results from insulin resistance, a condition in which cells fail to use insulin properly, sometimes combined with an absolute insulin deficiency. (Formerly referred to as non-insulin-dependent diabetes mellitus, NIDDM for short, and adult-onset diabetes.)
Type 2 diabetes mellitus is characterized by insulin resistance which may be combined with relatively reduced insulin secretion.
Signs and Symptoms:
The classic symptoms of diabetes are polyuria (frequent urination), polydipsia (increased thirst) and polyphagia (increased hunger).
Diagnosis
Diabetes mellitus is characterized by recurrent or persistent hyperglycemia and is diagnosed by demonstrating any one of the following
- Fasting plasma glucose level ≥ 7.0 mmol/L (126 mg/dL).
- Plasma glucose ≥ 11.1 mmol/L (200 mg/dL) two hours after a 75 g oral glucose load as in a glucose tolerance test.
- Symptoms of hyperglycemia and casual plasma glucose ≥ 11.1 mmol/L (200 mg/dL).
- Glycated haemoglobin (Hb A1C) ≥ 6.5%
Diabetes codes in ICD-10-CM are combination codes, including
- Type of diabetes
- Body System Involved
- Complication
Example:
- E10.311 Type 1 diabetes mellitus with unspecified diabetic retinopathy with macular edema
- E10.52 Type 1 diabetes mellitus with diabetic peripheral angiopathy with gangrene
- If the type of diabetes is not mentioned in the documentation, query the physician or assign the code E11.- Type 2 Diabetes.
- Assign the code Z79.4 for long-term use of insulin-Example- LANTUS ( insulin)
Example:
Type-2 DM with Gas Gangrene – E11.52 and A48.0
- If a patient is treated with both insulin and an injectable non-insulin antidiabetic drug, use codes Z79.4 (long-term [current] use of insulin) and Z79.85 (long-term [current] use of injectable non-insulin antidiabetic drugs).
- For a patient treated with both oral hypoglycemic drugs and an injectable non-insulin antidiabetic drug, assign codes Z79.84 (long-term [current] use of oral hypoglycemic drugs) and Z79.85.
In ICD-10-CM, 5 categories of Diabetes conditions were described. The codes are specific and stress precise documentation.
- E08 Diabetes mellitus due to underlying condition. This category is reserved for individuals who develop diabetes mellitus as the result of an underlying condition such as malignancy, malnutrition, and pancreatitis.
Example: *** What are the appropriate ICD-10-CM codes that should be reported for a patient undergoing treatment for diabetes accompanied by hypoglycemia and coma, attributed to a malignant neoplasm of the pancreas? The patient routinely uses insulin but is not considered insulin-dependent.
- E11.649, C25.9
- C25.9, E10.65, Z79.4
- C25.9, E08.65, Z79.4
- E08.649, C25.9
In the Tabular List, an instructional note under category code E08 indicates to code first the underlying condition. The neoplasm code is reported first. For patients who routinely use insulin, use code Z79.4 (ICD-10-CM guideline I.C.4.a.6.a.), which is found in the Alphabetic Index under Long-term (current) (prophylactic) drug therapy (use of)/insulin Z79.4. Verify code selection in the Tabular List.
- E09 Drug or chemical-induced diabetes mellitus.
- E10 Type 1 diabetes mellitus
- E11 Type 2 diabetes mellitus
- E13 Other specified diabetes mellitus. This category includes diabetes mellitus due to genetic defects of beta-cell function and insulin action. It also includes postprocedural diabetes mellitus, including post pancreatectomy diabetes mellitus.
NOTE: If Diabetes is not confirmed, assign any one code from these
Other hypoglycemia – E16.1 (New code 2025) – Assign additional code from E16.A-category0-CM Coding
Impaired fasting glucose R73.01
Impaired glucose tolerance R73.02
Prediabetes – R73.3
Other abnormal glucose – R73.09
Hyperglycemia – R73.9
Hypoglycemia unspecified – E16.2 (New code 2025) – Assign additional code from E16.A-category
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