ICD-10 Coding for Abnormal Glucose(R73.03, R73.09)
Complete ICD-10-CM coding and documentation guide for Abnormal Glucose. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Abnormal Glucose
R73.0-R73.9Primary Range
Abnormal glucose levels, including prediabetes and unspecified hyperglycemia
This range covers various abnormal glucose conditions that are not classified as diabetes.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| R73.03 | Prediabetes | Use when prediabetes criteria are met with documented lab results. |
|
| R73.09 | Other abnormal glucose | Use when glucose levels are abnormal but do not meet prediabetes criteria. |
|
Clinical Decision Support
Always review the patient's clinical documentation thoroughly. When in doubt, choose the more specific code and ensure documentation supports it.
Key Information: ICD-10 code for prediabetes
Essential facts and insights about Abnormal Glucose
Primary ICD-10-CM Codes for abnormal glucose
Decision Criteria
clinical Criteria
- Fasting glucose between 100-125 mg/dL
Applicable To
- Fasting glucose 100-125 mg/dL
- A1C 5.7-6.4%
Excludes
- Diabetes mellitus (E10-E14)
Clinical Validation Requirements
- Two abnormal fasting glucose tests
- Concordant results across different tests
Code-Specific Risks
- Misclassification as diabetes
- Insufficient documentation of lab values
Coding Notes
- Ensure lab results are documented to support prediabetes diagnosis.
R73.09 - Other abnormal glucose
Use when glucose levels are abnormal but do not meet prediabetes criteria.
Applicable To
- Borderline glucose levels
- Inconsistent lab results
Excludes
- Diabetes mellitus (E10-E14)
Clinical Validation Requirements
- Single abnormal glucose value
- Conflicting test results
Coding Notes
Document specific lab values to justify the use of this code.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting Abnormal Glucose to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code R73.03.
Impact
Clinical: Misdiagnosis risk, Regulatory: Non-compliance with coding standards, Financial: Potential claim denials
Mitigation Strategy
Always document specific lab values.
Impact
Reimbursement: Incorrect DRG assignment, Compliance: Non-compliance with coding guidelines, Data Quality: Inaccurate patient records
Mitigation Strategy
Use R73.03 if diagnostic criteria are met.
Impact
Using incorrect codes for glucose levels can lead to audits.
Mitigation Strategy
Ensure lab values are documented and match the coded diagnosis.
Documentation errors, coding pitfalls, and audit risks are interconnected aspects of medical coding and billing. Addressing all three areas helps ensure accurate coding, optimal reimbursement, and regulatory compliance.
Frequently Asked Questions
Common questions about ICD-10 coding for Abnormal Glucose, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Abnormal Glucose
Use these documentation templates to ensure complete and accurate documentation for Abnormal Glucose. These templates include all required elements for proper coding and billing.
Primary Care Evaluation
Specialty: Primary CareRequired Elements
- Fasting glucose level
- A1C percentage
- Patient history
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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