ICD-10 Coding for ICD-10-CM Database(E11.9, I11.0)
Complete ICD-10-CM coding and documentation guide for ICD-10-CM Database. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to ICD-10-CM Database
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.9 | Type 2 diabetes mellitus without complications | Use when diabetes is diagnosed without any specified complications. |
|
| I11.0 | Hypertensive heart disease with heart failure | Use when heart failure is due to hypertension. |
|
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: What is the ICD-10-CM database?
Essential facts and insights about ICD-10-CM Database
Primary ICD-10-CM Codes for database
Decision Criteria
clinical Criteria
- Diagnosis of Type 2 diabetes confirmed by lab tests.
Applicable To
- Non-insulin-dependent diabetes mellitus
Excludes
- Type 1 diabetes mellitus (E10.-)
Clinical Validation Requirements
- Fasting glucose >126 mg/dL
- HbA1c >6.5%
Code-Specific Risks
- Ensure no complications are documented in the medical record.
Coding Notes
- Ensure accurate documentation of diabetes type and treatment.
I11.0 - Hypertensive heart disease with heart failure
Use when heart failure is due to hypertension.
Applicable To
- Hypertensive heart failure
Excludes
- Hypertensive heart and chronic kidney disease (I13.-)
Clinical Validation Requirements
- Echocardiogram showing heart failure
- Blood pressure readings >140/90 mmHg
Coding Notes
Document the relationship between hypertension and heart failure.
Ancillary Codes
Additional codes that should be used in conjunction with the main diagnosis codes when applicable.
Long term (current) use of insulin
Z79.4Differential Codes
Alternative codes to consider when ruling out similar conditions to the primary diagnosis.
Documentation & Coding Risks
Avoid these common documentation and coding issues when documenting ICD-10-CM Database to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.9.
Impact
Clinical: Misinterpretation of diagnosis., Regulatory: Non-compliance with coding standards., Financial: Potential claim rejections.
Mitigation Strategy
Double-check code entries., Use electronic coding tools.
Impact
Reimbursement: Incorrect sequencing can lead to claim denials., Compliance: Non-compliance with coding guidelines., Data Quality: Inaccurate clinical data representation.
Mitigation Strategy
Follow 'code first' notes and sequence underlying conditions before manifestations.
Impact
Inaccurate documentation of diabetes complications.
Mitigation Strategy
Regular training on documentation requirements.
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 ICD-10-CM Database, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for ICD-10-CM Database
Use these documentation templates to ensure complete and accurate documentation for ICD-10-CM Database. These templates include all required elements for proper coding and billing.
Acute Myocardial Infarction
Specialty: CardiologyRequired Elements
- Chief complaint
- Past medical history
- Physical exam findings
- Lab results
- Imaging studies
- Assessment and plan
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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