ICD-10 Coding for Type 2 Diabetes Mellitus with Neuropathy(E11.42, E11.43)
Complete ICD-10-CM coding and documentation guide for Type 2 Diabetes Mellitus with Neuropathy. Includes clinical validation requirements, documentation requirements, and coding pitfalls.
Also known as:
Related ICD-10 Code Ranges
Complete code families applicable to Type 2 Diabetes Mellitus with Neuropathy
E11.4-Primary Range
Type 2 diabetes mellitus with neurological complications
This range includes codes for type 2 diabetes with various types of neuropathy, which are the primary codes for documenting diabetic neuropathy.
Code Comparison: When to Use Each Code
Compare key differences between these codes to ensure accurate selection
| Code | Description | When to Use | Key Documentation |
|---|---|---|---|
| E11.42 | Type 2 diabetes mellitus with diabetic polyneuropathy | Use when polyneuropathy is confirmed and linked to diabetes. |
|
| E11.43 | Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy | Use when autonomic neuropathy is confirmed and linked to diabetes. |
|
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 type 2 diabetes with neuropathy
Essential facts and insights about Type 2 Diabetes Mellitus with Neuropathy
Primary ICD-10-CM Codes for diabetes mellitus type 2 with neuropathy
Decision Criteria
clinical Criteria
- Confirmed diabetic polyneuropathy through clinical tests
documentation Criteria
- Explicit mention of 'diabetic polyneuropathy' in patient records
Applicable To
- Diabetic polyneuropathy
Excludes
- Polyneuropathy due to other causes (G62.9)
Clinical Validation Requirements
- Nerve conduction studies confirming polyneuropathy
- Symptoms such as numbness or tingling in extremities
- HbA1c >6.5%
Code-Specific Risks
- Incorrectly using E11.40 when polyneuropathy is specified
Coding Notes
- Ensure documentation explicitly links neuropathy to diabetes using terms like 'due to' or 'associated with'.
E11.43 - Type 2 diabetes mellitus with diabetic autonomic (poly)neuropathy
Use when autonomic neuropathy is confirmed and linked to diabetes.
Applicable To
- Diabetic autonomic neuropathy
Excludes
- Autonomic neuropathy due to other causes (G90.9)
Clinical Validation Requirements
- Symptoms such as gastroparesis or orthostatic hypotension
- Autonomic function tests
Coding Notes
Document specific autonomic symptoms and their management.
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 Type 2 Diabetes Mellitus with Neuropathy to ensure proper reimbursement, maintain compliance, and reduce audit risk. These guidelines are particularly important when using ICD-10 code E11.42.
Impact
Clinical: May lead to inappropriate treatment plans., Regulatory: Increases risk of audit and compliance issues., Financial: Potential for reduced reimbursement due to unspecified coding.
Mitigation Strategy
Ensure thorough documentation of symptoms and test results., Regular training on documentation standards.
Impact
Reimbursement: Unspecified codes may lead to lower reimbursement rates., Compliance: Increases risk of audit due to lack of specificity., Data Quality: Reduces accuracy of health data and impacts quality reporting.
Mitigation Strategy
Ensure documentation specifies the type of neuropathy, allowing use of E11.42 or E11.43.
Impact
Using codes like E11.40 without specifying neuropathy type can trigger audits.
Mitigation Strategy
Ensure documentation specifies the type of neuropathy and its linkage to diabetes.
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 Type 2 Diabetes Mellitus with Neuropathy, with expert answers to help guide accurate code selection and documentation.
Documentation Templates for Type 2 Diabetes Mellitus with Neuropathy
Use these documentation templates to ensure complete and accurate documentation for Type 2 Diabetes Mellitus with Neuropathy. These templates include all required elements for proper coding and billing.
Documenting diabetic polyneuropathy in a patient with type 2 diabetes
Specialty: EndocrinologyRequired Elements
- Patient's HbA1c level
- Symptoms of neuropathy
- Nerve conduction study results
- Linkage of neuropathy to diabetes
Example Documentation
Examples: Poor vs. Good Documentation
Poor Documentation Example
Good Documentation Example
Explanation
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